Pain Catastrophizing: Making a Mountain Out of a Mole Hill

Psychosocial factors have become increasingly recognized as important moderators and determinants of the pain experience. One such factor that has garnered great empirical attention is pain catastrophizing. Pain catastrophizing has been described for more than half a century, yet many frontline practitioners continue to be unfamiliar with the construct. It is conceptualized as a negative cognitive affective response to anticipated or actual pain and has been associated with a number of important pain related outcomes.

There are several determinants for pain catastrophizing, including female sex, Asian/African race, age, certain genotypes, and hormonal/neurophysiological phenotypes.

There are two psychometrically sound self-report instruments (Coping Strategies Questionnaire and CSQ and the Pain Catastrophizing Scale) that can be readily and reliably used with a variety of pain populations. High levels of pain catastrophizing on these measures should be considered a risk marker for adverse pain related outcomes.

The primary treatment for pain catastrophizing is cognitive behavior therapy for chronic pain (CBT-CP). Education, relaxation, and acceptance and commitment therapy (ACT) skills have also shown promise.