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Chronic non-specific neck pain (CNSNP) is a common condition and its relationship to the pain catastrophizing construct in terms of sensorimotor functions and dual task performance is not fully understood. We aimed to investigate the differences in sensorimotor integration, cervical sensorimotor control, and cognitive-motor dual tasking abilities between CNSNP patients (> 3 months) with high versus low catastrophizing tendencies and healthy controls. Ninety participants were recruited, 30 asymptomatic controls, and 60 patients with CNSNP; 30 scoring high (> 75th percentile) and 30 scoring low (< 25th percentile) on the pain catastrophizing scale (PCS). The variables of sensorimotor integration (frontal N30 amplitude), cervical sensorimotor control (head repositioning accuracy (HRA) - left and right), and cognitive-motor dual tasking (percentage of gait speed time increase with a cognitive load) were assessed and compared across groups. In general, performance of sensorimotor integration, cervical sensorimotor control, and cognitive-motor dual tasking abilities was incrementally better comparing the high to low catastrophizing groups, and the low catastrophizing group to the controls. Correlation coefficients between PCS and HRA (left and right) was strong (r = .8, p < 0.001), between PCS and dual tasking cost was moderate (r = .7, p < 0.001), and between PCS and frontal N30 amplitude was moderate (r = .57, p < 0.001). In conclusion, we found that higher pain catastrophizing was associated with poorer sensorimotor integration, cervical sensorimotor control, and cognitive-motor dual tasking in CNSNP patients highlighting the importance of both assessing and treating catastrophizing in the treatment of CNSNP. PERSPECTIVE: This study highlights the significant impact of pain catastrophizing on sensorimotor integration, cervical sensorimotor control, and cognitive-motor dual tasking in CNSNP patients. High catastrophizers are particularly vulnerable to these impairments, suggesting the need for comprehensive treatment approaches that address both psychological as well as physical components., Competing Interests: Declaration of Competing Interest PAO is a paid consultant for CBP NonProfit, Inc. DEH is the president of CBP NonProfit. DEH teaches rehabilitation methods and is the CEO of a company that distributes healthcare products to physicians in the U.S.A.; none of these devices were used in this investigation or manuscript. All the other authors declare that they have no competing interests., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Symptoms of posttraumatic stress disorder (PTSD) are highly prevalent among Veterans with chronic pain. Considerable research has examined the intersection of chronic pain and PTSD symptoms. However, it remains unclear whether changes in PTSD may potentially serve a mechanistic role in improving unhelpful pain cognitions for individuals with chronic pain. The present research contributes to the foundational knowledge by addressing this question. Baseline data from a randomized controlled trial targeting pain-related disability for Veterans ( n  = 103; mean age 43.66; SD  = 10.17) with musculoskeletal pain and depression and/or PTSD symptoms were used. Cross-sectional mediation analyses showed that PTSD symptoms mediated the relationship between pain severity and pain catastrophizing, and between pain severity and pain acceptance. After controlling for depression, the mediation involving pain catastrophizing remained significant, while the mediation for pain acceptance did not. Although limitations exist, results point to several treatment recommendations, including ensuring that depressive affect, PTSD-specific symptoms, and attention to both body and mind are included in treatment. Results also provide preliminary evidence for examining these associations longitudinally to improve our understanding of this population and corresponding treatment recommendations.

Background: It is clinically important to anticipate the likelihood of pain catastrophizing in patients who undergo total knee arthroplasty (TKA). Persistent pain and diminished physical function following TKA are independently associated with preoperative pain catastrophizing. The purpose of this study was to develop and validate a nomogram model to predict pain catastrophizing in patients who have severe osteoarthritis undergoing primary TKA., Methods: Data were collected from patients who have severe osteoarthritis undergoing primary TKA at four tertiary general hospitals in Changsha, China, from September to December 2023. The study cohort was randomly divided into a training group and a validation group in the proportion of 70 to 30%. Least absolute shrinkage and selection operator regression analysis was utilized to select the optimal predictive variables for the model. A nomogram model was created using independent risk factors that were identified through multivariate regression analysis. Their performance was assessed using the concordance index and calibration curves, and their clinical utility was analyzed using decision curve analysis., Results: A total of 416 patients were included, 291 in the training group and 125 in the validation group. There were 115 (27.6%) who had pain catastrophizing. The predictors contained in the nomogram were pain intensity during activity, anxiety and depression, body mass index, social support, and household. The area under the curve of the nomogram was 0.976 (95% confidence interval = 0.96 to 0.99) for the training group and 0.917 (95% confidence interval = 0.88 to 0.96) for the validation group. The calibration curves confirmed the nomogram's accuracy, and decision curve analysis showed its strong predictive performance., Conclusions: The comprehensive nomogram generated in this study was a valid and easy-to-use tool for assessing the risk of pain catastrophizing in preoperative TKA patients, and helped healthcare professionals to screen the high-risk population., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: This study aimed to examine the relationship between pain catastrophizing (PC) and health-related quality of life (HRQoL), while accounting for pain intensity and other factors in patients with hip osteoarthritis (OA)., Methods: This multicenter, cross-sectional study included a total of 160 participants and was conducted at five hospitals in Japan. The primary outcome was the HRQoL status, which was assessed using the Japanese version of the 12-item Short Form. Physical (PCS-12) and mental (MCS-12) component summary scores were used as dependent variables. Age, sex, body mass index (BMI), affected side, hip OA severity, bilateral range of motion (ROM), muscle strength, pain intensity, and PC scale scores were measured as independent variables. After screening, multiple regression analysis was performed for each outcome., Results: Higher BMI (β = -0.17, p < 0.05), higher hip flexion ROM on the unaffected side (β = -0.26, p < 0.05), lower hip flexion ROM on the affected side (β = 0.22, p < 0.05) and higher PC scale score (β = -0.28, p < 0.05) were associated with worse PCS-12. In addition, higher BMI (β = -0.18, p < 0.05) and higher PC scale scores (β = -0.29, p < 0.05) were associated with worse MCS-12 after accounting for confounding factors., Conclusion: This study suggested that PC is an issue in patients with hip OA and is a potential target for interventions aimed at improving HRQoL., (© 2024 John Wiley & Sons Ltd.)

Background: Although a few studies have delineated the disparities in knee osteoarthritis (KOA) pain between non-Hispanic White and Asian American individuals, a significant research gap persists in elucidating the mechanisms underlying these differences., Objective: This pilot study aims to examine psychological factors, specifically pain catastrophizing and negative affect, as potential explanatory mechanisms for these dissimilarities., Methods: A cross-sectional design was used. Forty community-dwelling participants aged 50-70 years with self-reported KOA pain, including 20 non-Hispanic White and 20 Asian American individuals, were recruited in North Central Florida. Clinical KOA pain intensity was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 4 subscales of the Short-Form McGill Pain Questionnaire-2. Quantitative sensory testing was conducted to measure experimental sensitivity to heat- and mechanically induced pain, including heat pain, pressure pain threshold, and punctate mechanical pain, as well as inhibitory pain processes through conditioned pain modulation. Pain catastrophizing was evaluated using the Coping Strategies Questionnaire-Revised Pain Catastrophizing subscale, while negative affect was assessed using the Positive and Negative Affect Schedule. Bayesian mediation analyses were used to examine both direct and indirect effects (mediation) between variables., Results: Asian American individuals exhibited higher pain catastrophizing scores than non-Hispanic White individuals. Pain catastrophizing, at high levels, contributed to WOMAC and Short-Form McGill Pain Questionnaire-2, which measured clinical pain. Race had no direct effects on these pain scores but exerted significant indirect effects via pain catastrophizing (WOMAC pain: 0.96, 95% CI 0.03-2.16; continuous pain: 0.84, 95% CI 0.18-1.70; intermittent pain: 0.78, 95% CI 0.03-1.71; neuropathic pain: 0.43, 95% CI 0.03-0.95; and affective pain: 1.05, 95% CI 0.24-1.99); thus, pain catastrophizing likely fully mediated the relationship between race and these pain measures. While Asian American individuals reported greater experimental pain sensitivity (heat pain, pressure pain threshold, and punctate mechanical pain) than non-Hispanic White individuals, these racial effects were not mediated by pain catastrophizing. Asian American individuals reported higher negative affect scores compared with non-Hispanic White individuals; however, negative affect did not mediate the relationship between race and any pain measures., Conclusions:  The results demonstrate the contribution of pain catastrophizing to clinical pain in Asian American individuals with KOA and identify it as a potential mechanism underlying group differences in KOA pain between non-Hispanic White and Asian American individuals. However, caution is warranted due to the exploratory nature of this study and the treatment of Asian American individuals as a monolithic sample. Hence, future replication with larger and more diverse samples is necessary. Additionally, the lack of mediation effects of pain catastrophizing in the relationship between race and experimental pain suggests the need to explore other factors, such as biological, genetic, social, and environmental influences. Moreover, further research is essential to clarify the role of negative affect., (©Chiyoung Lee, C. Kent Kwoh, Juyoung Park, Lindsey Park, Hyochol Ahn. Originally published in the Asian/Pacific Island Nursing Journal (https://apinj.jmir.org), 25.02.2025.)

Spiritual wellbeing correlates with improved pain perception. We hypothesize that pain catastrophizing, which correlates with worsened pain, partially explains this relationship. In this cross-sectional, human laboratory-based study, 120 US Americans with chronic pain completed self-report measures of spiritual wellbeing, pain catastrophizing, and their subconstructs. A cold pressor task measured pain perception (i.e. pain sensitivity and pain tolerance). Multiple regressions evaluated the relationship between spiritual wellbeing (and its subconstructs) and pain perception with and without the inclusion of pain catastrophizing (and its subconstructs). No direct relationships were found between spiritual wellbeing or its subconstructs and pain sensitivity, although helplessness significantly altered regression coefficients. Spiritual wellbeing, meaning, and peace associated less strongly with pain tolerance controlling for pain catastrophizing, helplessness, and (for peace) magnification. This shows that many of the links between spiritual wellbeing and pain perception are indirect, through pain catastrophizing and especially helplessness., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This study aimed to compare the efficacy of two neuromodulation techniques, peripheral nerve stimulation (PNS) and pulsed radiofrequency (PRF), in patients with acute zoster-related trigeminal neuropathic pain with pain catastrophizing., Materials and Methods: A total of 65 patients with acute zoster-related trigeminal neuropathic pain and pain catastrophizing were recruited from the Department of Pain Management of the Affiliated Hospital of Southwest Medical University between March 2019 and March 2024. According to the order of enrollment, participants were randomly assigned to two groups: the PNS group (n = 31), which received stimulation of the supraorbital nerve, and the PRF group (n = 34), which underwent PRF treatment of the same nerve. Pain levels were assessed using a visual analog scale (VAS), and the dosage of the anticonvulsant pregabalin was recorded at baseline, one week, two weeks, one month, three months, and six months postoperatively. Additionally, patients were evaluated using the Pain Catastrophizing Scale (PCS) and the Short Form 36 (SF-36) Health Survey at baseline and one, three, and six months postoperatively. Both groups were also monitored for adverse events and patient satisfaction throughout the study period., Results: Both the PNS and PRF groups experienced significant pain relief. However, the PNS group demonstrated superior outcomes compared with the PRF group at both short-term follow-up time points (p < 0.05). No significant difference in VAS scores was observed between the PNS and PRF groups during the long-term (six-month) follow-up. Improvements were noted in the SF-36 (across all eight dimensions) and PCS scores in both groups following treatment (p < 0.05). Notably, the PCS scores in the PNS group were consistently lower than those in the PRF group at all follow-up time points (p < 0.05). Additionally, patients in the PNS group exhibited greater improvements in physical role limitations, somatic pain, general health, social functioning, emotional role limitations, and mental health compared with those in the PRF group (p < 0.05). There were no significant differences between the two groups regarding improvements in physical functioning and vigor. After treatment, the average daily dose of pregabalin (mg/d) was reduced in both groups, with patients in the PNS group requiring a lower dose than those in the PRF group. Furthermore, patients in the PNS group reported a significantly higher level of satisfaction (p < 0.05) based on satisfaction evaluations. No instances of bleeding, infection, or other adverse effects were observed in either group after treatment., Conclusion: Both PNS and PRF are effective and feasible for managing pain in patients with acute zoster-related trigeminal neuropathic pain and pain catastrophizing. However, PNS demonstrates superior efficacy in terms of early pain relief, reduction of pain catastrophizing, and improvements in quality of life, accompanied by higher patient satisfaction compared with PRF., Competing Interests: Conflict of Interest The authors reported no conflict of interest., (Copyright © 2025 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)

Background: Pain catastrophizing has been linked to poorer patient-reported pain outcomes for orthopedic surgery, but its effect on perioperative pain and narcotic use is poorly understood. Our purpose was to determine if pain catastrophizing has a negative effect on perceptions of perioperative pain and narcotic use in patients undergoing posterior spinal fusion (PSF) for idiopathic scoliosis (IS)., Methods: A retrospective, IRB-approved review of prospectively collected data of IS patients undergoing PSF. Patients were considered PCs when they scored above the 75th percentile in the PCS (total score ≥ 30). Inpatient narcotic consumption was calculated as morphine equivalent per Kg (mEq/Kg)., Results: Five hundred seventeen patients (411F, 106M) underwent PSF for IS. Forty-five (8.7%) patients were pain catastrophizers (PCs). PC patients had significantly lower pain, appearance, and mental scores. PCs scored slightly higher on VAS pain scores (2.20 vs 1.92, p = 0.015) in the first 24 h only. There were no differences in opioid use between PC vs. non-PC cohorts for inpatient (2.01 vs 2.14 mEq/Kg, p = 0.4), discharge (5.6 vs 5.87 mEq/Kg, p = 0.3), or total narcotics (7.61 v 8.01 mEq/Kg, p = 0.2). Fifty-five patients out of five hundred seventeen requested narcotic refills with no difference in refill rates between cohorts (p = 0.7076)., Conclusion: We found that pain catastrophizers had lower pre-operative SRS-30 scores across all domains except satisfaction. We found no association between pain catastrophizing and increased opioid use in either the inpatient stay or post-discharge. While pain catastrophizing has been associated with lower pre- and post-operative pain scores, it does not appear to predispose to higher narcotic utilization perioperatively., Level of Evidence: II: retrospective comparative study., Competing Interests: Declarations. Competing interests: Dr. Elaine Tran, Mr. David Thornberg, Ms. Anne-Marie Datcu, Dr. Chan-Hee Jo, and Dr. Brandon Ramo have no relevant financial or non-financial interest to disclose. Ethics approval: IRB approval was received before the study began. Participants were prospectively enrolled and informed consent was obtained prior to initiation. (IRB #022011–127)., (© 2025. The Author(s), under exclusive licence to Scoliosis Research Society.)

Background: This study explores the relationship between primary dysmenorrhea (PD), pain, pain catastrophizing, and menstruation-related quality of life in young women., Methods: A cross-sectional study was conducted involving 44 young women, both with and without PD. Various variables including pain intensity, pain catastrophizing, and menstruation-related quality of life were assessed using validated questionnaires. Correlation and regression analyses were performed to examine the relationships between the variables., Results: Significant associations were found between the presence of PD, tendency to catastrophize pain, and decreased menstruation-related quality of life. A high correlation was observed between pain intensity and catastrophizing, indicating mutual influence between these variables. Menstruation-related quality of life was affected in terms of health perception, psychological aspect, and symptoms among women with PD. The linear regression model demonstrated that catastrophizing explained 42.8% of the variance in menstruation-related quality of life., Conclusions: These findings underscore the importance of addressing dysmenorrhea in young women, as it significantly impacts their quality of life related to menstruation. Understanding the factors contributing to dysmenorrhea and its effects on quality of life can inform more effective, patient-centered treatment strategies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2025 Del Prado, García-Arrabé, González-de-la-Flor, De La Plaza San Frutos, Almazán Polo, Guérineau and Estrada-Barranco.)

Pain catastrophizing is understood as a negative cognitive and emotional response to pain. Researchers, clinicians, advocates, and patients have reported stigmatizing effects of the term on patients when used clinically and in the media. This report describes the results of an international, observational, cross-sectional study investigation of clinician and researcher (professionals) perspectives on the term pain catastrophizing and whether new terminology is needed or desired. Open-ended electronic surveys were distributed to researchers and clinicians by collaborators, stakeholders, and through social media. Professionals reported on their familiarity with the term, its meaning and impacts, and their use of the term with patients. 1397 surveys from professionals in 46 countries (48.5% from the U.S.) were received. The sample was almost two-thirds female (61.3%), with a mean age of 56.67 (SD=4.04) years, and comprised of 78.6% clinicians (63.6%, pain specialists; n=698) and 20.3% researchers. The majority were familiar with the term (82.2%; n=1148). Among the 1098 clinicians, 33.6% had used the term in communication with patients. A content analysis of professionals' responses to open-ended questions is presented. Coded responses were synthesized into five content categories or themes: (1) pain catastrophizing is an exaggerated response to pain; (2) pain catastrophizing is an unhelpful response to pain; (3) the term pain catastrophizing is stigmatizing; (4) the term pain catastrophizing is clinically useful; (5) patients' perception of the term varies. Results highlight the continual controversy surrounding the term pain catastrophizing and the need for additional research and education to incorporate patient-centered approaches into clinical and public communications. Perspective: We present a content analysis of international clinician and researcher perspectives on the term pain catastrophizing. This investigation provides the largest depiction to date of the controversy surrounding pain catastrophizing and may guide future efforts to decrease stigma in patients with chronic pain and improve patient-clinician communication., (Copyright © 2025. Published by Elsevier Inc.)

This study investigated the relationship between neighborhood disadvantage, measured by the Area Deprivation Index (ADI), and pain-related variables in a pain psychology clinic. We also examined the sequential mediating roles of pain catastrophizing and pain-related fear on these relationships. Participants (N = 509) completed questionnaires assessing usual pain intensity, fatigue, emotional distress, and interference with daily activities. The mean ADI score was 32.57 (SD = 22.65), with scores ranging from 1 to 100. Linear regression analysis, adjusting for age and gender, revealed that higher ADI (i.e., less advantage) was significantly associated with higher scores on pain-related variables (pain intensity: B = 0.026, p < .001; fatigue: B = 0.018, p < .001; emotional distress: B = 0.020, p < .001; interference with daily activities: B = 0.014, p = .006). Sequential mediation analysis revealed pain catastrophizing and pain-related fear mediated these relationships, with significant indirect effects for fatigue (B = 0.001, 95% CI [0.000, 0.002]) and interference with daily activities (B = 0.001, 95% CI [0.001, 0.003]) - but not pain intensity or emotional distress. Pain catastrophizing alone mediated neighborhood disadvantage-pain relationship for all variables. The results suggest that neighborhood disadvantage is associated with higher scores on pain-related experiences and that consistent with the fear avoidance model, pain catastrophizing and pain-related fear may play a role in these relationships for fatigue and interference with daily activities. These findings underscore that neighborhood disadvantage is associated with worse pain-related experiences and highlight the importance of considering neighborhood factors in chronic pain management. PERSPECTIVE: This study identifies potential pathways linking neighborhood disadvantage to chronic pain variables, highlighting the roles of pain catastrophizing and pain-related fear. The findings underscore the need for a holistic approach to pain management that recognizes both individual cognitive-emotional factors and the broader social context in which pain occurs., Competing Interests: Declaration of Competing Interest All authors declare they have no conflicts of interest or known competing financial interest or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Objectives: This study was designed to test whether a negative affect phenotype reflecting depression, anxiety, anger, and pain catastrophizing predicts inpatient and outpatient opioid use outcomes following cardiac surgery., Design: In a single-center prospective observational pilot study, the authors obtained validated measures of negative affect and opioid-related phenotype preoperatively and collected opioid use and opioid misuse-related outcomes at 30-day postoperative follow-up., Setting: Quaternary medical center., Participants: The final dataset included 30 adult patients undergoing elective cardiac surgery procedures between August 19, 2022, and August 29, 2023., Interventions: None., Measurements and Main Results: Opioid outcomes included: (1) total inpatient postoperative opioid use (in milligram morphine equivalents), (2) self-reported number of days that prescribed outpatient opioids were used during the 30-day follow-up period (Timeline Followback method), and (3) number of opioid misuse-related behaviors (Current Opioid Misuse Measure-9) at 30-day follow-up. Generalized linear model analyses using a Poisson distribution indicated that greater preoperative depression, anxiety, anger, pain catastrophizing, and opioid misuse risk (indexed by the Screener and Opioid Assessment for Patients with Pain- Revised) were all significantly (p < 0.002) associated with greater inpatient and outpatient postoperative opioid use, as well as more opioid misuse-related behaviors at 30-day follow-up (p < 0.001)., Conclusions: Patients with higher preoperative levels of negative affect (depression, anxiety, anger, and pain catastrophizing) use more inpatient and outpatient opioid analgesics following cardiac surgery, a pattern similar to noncardiac surgery populations. Results support further study of patient-specific approaches to opioid prescribing to reduce the risk for opioid use disorder post-cardiac surgery., Competing Interests: Declaration of competing interest The authors declare the following financial interests and/or personal relationships that may be considered potential competing interests: Stephen Bruehl reports a relationship with Akigai that includes consulting or advisory. Stephen Bruehl reports a relationship with the National Institute on Drug Abuse that includes funding grants. Daniel B. Larach reports a relationship with the National Institute on Drug Abuse that includes funding grants. The other authors declare known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Substance use disorder (SUD) and pain are highly comorbid conditions and several pain indices (e.g., pain intensity) are associated with an increased risk of relapse. However, the cognitive-emotional experience of pain (i.e., pain catastrophizing) is understudied in SUD recovery. Further, how the association between pain catastrophizing and delay discounting - a posited biomarker of addiction, impacts multidimensional aspects of SUD recovery, including remission and quality of life (QOL), has yet to be examined., Methods: Individuals (n = 170) in SUD recovery reporting pain were asked about their chronic pain status, completed the Brief Pain Inventory, the Pain Catastrophizing Scale, an Adjusting Amount Delay Discounting Task, and the World Health Organization QOL-BREF scale. Univariate logistic and linear regressions examined associations between delay discounting and several pain indices with remission and QOL. Mediation analyses were investigated whether pain catastrophizing mediates the relationship between delay discounting and 1) sustained remission and 2) QOL., Results: Significant negative associations were found between delay discounting (p < .001) and pain catastrophizing (p = .001) with sustained remission. Pain catastrophizing significantly mediated the relationship between delay discounting and physical QOL (p = .044), psychological QOL (p = .009), social (p = .018), and environmental QOL (p = .014). Pain catastrophizing did not mediate the relationship between DD and sustained remission., Conclusion: Individuals with greater DD exhibited greater pain catastrophizing, contributing to poorer QOL in SUD recovery. Our findings support that a Reinforcer Pathology framework is useful to understanding the cognitive-emotional experience of pain within the context of SUD recovery. Interventions that target both delay discounting and maladaptive cognitive and emotional responses to pain may lessen the negative impact of pain on SUD recovery and improve SUD outcomes., Competing Interests: Declaration of competing interest Although the following activities/relationships do not create a conflict of interest pertaining to this manuscript, in the interest of full disclosure, Dr. Bickel would like to report the following: W. K. Bickel is a principal of HealthSim, LLC; BEAM Diagnostics, Inc.; and Red 5 Group, LLC. In addition, he serves on the scientific advisory board for Ria Health; and serves as a consultant for Lumanity. Dr. Tegge would like to report the following works on a project supported by Indivior, Inc. None of the other authors has any conflicts of interest to report., (Copyright © 2024. Published by Elsevier Inc.)

Objective: Parental anxiety and/or catastrophizing may bias the interpretation of children's pain and administration of analgesia post-tonsillectomy. We aimed to determine whether high levels of parental anxiety and/or catastrophizing impact child pain intensity interpretation and administration of analgesia., Methods: Child-parent dyads were recruited from a tertiary care institution between July 2017-December 2019. Preoperative parental anxiety and catastrophizing were assessed using self-report measures. Postoperative data on child and parent pain intensity, as well as analgesia use, were collected up to 2 weeks post-surgery. Multivariable logistic regression models were created to assess predictors of postoperative child pain intensity and analgesia use., Results: Our cohort included 234 child-parent dyads. Median child age was 5 years (IQR, 4-6), and 9.0 % of children (n = 21) had a medical comorbidity. Both child- and parent-reported pain intensity were highest on postoperative day 2 (3.65 [SD = 3.08] and 3.67 [SD = 2.51], respectively). Parental catastrophizing did not predict analgesia use at home, although a minimal significant decrease in the odds of analgesia administration was observed on postoperative day 7 (OR 0.932, p = 0.017). Maximal parental anxiety did not predict higher odds of increased child postoperative pain intensity on any postoperative day., Conclusion: Parental catastrophizing prior to tonsillectomy has minimal predictive value for analgesia use postoperatively. Children may be successfully advocating for their own pain control as parental anxiety and catastrophizing do not appear to be unduly influencing analgesia administration. Future studies should explore the impact of parental anxiety on vulnerable pediatric populations who may be unable to self-advocate for pain management., Competing Interests: Declaration of competing interest No conflict., (Copyright © 2025. Published by Elsevier B.V.)

Presenteeism has been noted to be associated with cognitive factors of pain, such as pain catastrophizing (PC) and pain self-efficacy (PS). Pain perception differs by gender, so it is important to consider gender differences when examining the association between cognitive factors of pain and presenteeism. This study aimed to examine the association between presenteeism and cognitive factors of pain, taking gender differences into account. A cross-sectional survey of 305 workers was conducted using a self-administered questionnaire that included items on pain status, PC, PS, and work performance. Multiple logistic regression analysis was used to test whether PC and PS independently influence presenteeism, separately for men and women. Logistic regression analysis showed that PC was extracted in men, and the group with severe PC had higher odds of presenteeism (odds ratio 6.56, 95% confidence interval [CI] 1.83-23.40). Contrarily, PS was extracted in women, with higher odds of presenteeism in the moderate (odds ratio 2.54, 95% CI 1.01-6.39) and low (odds ratio 5.43, 95% CI 1.31-22.50) PS groups than in the high PS. This study showed that the cognitive factors of pain related to presenteeism may differ by gender.

Background: Ankle joint position sense (AJPS) accuracy and postural control are crucial for maintaining balance and stability, particularly in individuals with plantar fasciitis who may experience proprioceptive and functional impairments. Understanding how psychosocial factors, such as pain catastrophizing, and biomechanical measures, like muscle strength and gait parameters related to proprioception and postural control, can inform more effective treatment approaches. This study aimed to (1) examine the relationship between AJPS accuracy and biomechanical factors-including postural stability, lower limb muscle strength, and gait parameters-in individuals with plantar fasciitis d (2) analyze the impact of psychosocial factors, including pain catastrophizing, physical activity level, and quality of life, on AJPS accuracy and postural control in this population., Methods: A total of 126 participants (63 with plantar fasciitis and 63 controls) were recruited. AJPS was assessed using a digital inclinometer across four movement directions (plantarflexion, dorsiflexion, inversion, eversion). Postural stability metrics (antero-posterior and medio-lateral sway) were measured using computerized posturography, while muscle strength in plantar flexors, dorsiflexors, inverters, and evertors was assessed with a hand-held dynamometer. Gait parameters (step length, cadence, stance time) were captured via 3D motion capture. Pain catastrophizing, physical activity, and quality of life were evaluated using validated questionnaires (PCS, IPAQ, FHSQ)., Results: Significant differences were observed in AJPS accuracy between groups, with plantar fasciitis patients showing higher AJPS error in plantarflexion (mean difference = 1.22°, p < 0.001) and dorsiflexion (mean difference = 1.31°, p < 0.001). Pain catastrophizing was a significant predictor of AJPS in plantarflexion (β = -0.05, p = 0.001). Postural stability was negatively correlated with AJPS accuracy, particularly in mediolateral sway (r = -0.32, p = 0.037), while physical activity and quality of life had minimal effects., Conclusion: This study highlights the impact of pain catastrophizing on proprioceptive deficits in plantar fasciitis, emphasizing the importance of addressing psychological as well as biomechanical factors in treatment. Integrating cognitive-behavioral strategies may enhance proprioceptive accuracy and stability outcomes in this population., Competing Interests: Declarations. Ethics approval and consent to participate: Ethical approval for this study was obtained from the Institutional Research Ethics Committee (REC) at King Khalid University (approval number ECM# 2023 − 356) on 13/05/2023. Consent for publication: All participants in the present study received instructions about the experimental procedures and content, and the experiments were conducted after they had completed the consent forms. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Objective. To investigate the relationships among neuropathic pain (NP), pain catastrophizing (PC), and central sensitization (CS) in relation to functional status and radiological damage in patients with knee osteoarthritis (OA). Methods. This cross-sectional study included knee OA patients derived from an observational cohort. The Spearman correlation test was used to analyze the relationship between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the PainDetect Questionnaire (PDQ), Central Sensitization Inventory (CSI), and Pain Catastrophizing Scale (PCS). The Kruskal-Wallis test was employed to compare WOMAC scores according to CSI categories. A multivariate analysis was conducted to identify predictors of functional ability, with the WOMAC score as the dependent variable and the independent variables including pain-related indices such as PCS, PDQ, and CSI, along with Kellgren-Lawrence (K-L) grading and demographic characteristics. Results. This study included 149 patients (76.5% female; mean age 71.5 years; mean duration of pain 8.1 years). In total, 23.5% exhibited NP, 30.9% showed PC, and 33.6% had CS. Higher mean values of WOMAC were correlated with CSI categories ( p < 0.0001). WOMAC showed a significant relationship with CSI (rho = 0.791; p < 0.0001), PDQ (rho = 0.766; p < 0.0001), and PCS (rho = 0.536; p < 0.0001). In the multiple regression analysis, WOMAC was independently associated with CSI ( p < 0.0001), PDQ ( p < 0.0001), and PC ( p = 0.0001). No association was observed between the K-L grading and the other variables. Conclusions. A reduced functional capacity in patients with knee OA is correlated with the presence of NP, PC and CS, without being significantly associated with radiological damage.

Background : Chronic pain affects about 20% of total knee arthroplasty (TKA) patients, with high pain catastrophizing being a key predictor. Screening and addressing this modifiable factor may improve postoperative outcomes. Objective : We aimed to compare the effectiveness of two preoperative home-based multimodal physical therapy interventions on pain catastrophizing in high-catastrophizing TKA patients. Secondarily, the study aimed to assess postoperative outcomes over six months. Methods : A total of 40 patients with symptomatic osteoarthritis and moderate pain catastrophizing were randomly allocated to the control, therapeutic patient education (TPE), and multimodal physiotherapy (MPT) groups. Preoperative interventions comprised pain neuroscience education, coping skills training, and therapeutic exercise, differing in the number of sessions and degree of supervision. All outcomes were assessed before and after the treatment in the preoperative period, and 1, 3, and 6 months post-surgery. The primary outcome measure was pain catastrophizing. Results : Both intervention groups showed a preoperative reduction in pain catastrophizing. TPE patients had lower pain ratings at rest and lower catastrophizing scores at 1 and 6 months post-surgery, reduced kinesiophobia and improved dynamic balance at 3 and 6 months post-surgery, and higher self-efficacy at 1 month post-surgery. MPT patients exhibited lower pain catastrophizing and pain intensity during walking at 1 month post-surgery, and better outcomes in kinesiophobia, self-efficacy, and dynamic balance at 1, 3, and 6 months post-surgery, along with higher walking speed at 6 months post-surgery. Conclusions : Preoperative physiotherapy reduces preoperative pain catastrophizing and improves postoperative pain-related outcomes, behaviors, and cognitions in high-catastrophizing TKA patients. Registration is with the United States Clinical Trials Registry (NCT03847324).

Interventions aimed at preventing chronic pain after acute traumatic injury have significant potential to reduce healthcare expenditures and improve quality of life for millions of individuals. Given recent development of such interventions, limited research has examined mechanisms of change using repeated measures (e.g., session-by-session assessments). This study examines within-person relationships between pain catastrophizing and intensity during and after a four-session mind-body intervention for individuals with acute traumatic orthopedic injury (N = 76, T = 445). Random intercept cross-lagged panel models were used to examine within-person autoregressive, contemporaneous, and cross-lagged effects between pain catastrophizing and pain intensity, after accounting for stable between-person differences. Our primary hypothesis that improvements in catastrophizing would be associated with subsequent reductions in pain intensity was partially supported by a significant within-person cross-lagged effect between catastrophizing at post-test and pain with activity reported at three-month follow-up (β = 0.421, SE = 0.099, p < .001). Improvement in catastrophizing was also associated with same-session improvement in pain intensity midway through the intervention. Importantly, bidirectional within-person analyses allowed us to rule out the possibility that improvements in pain were responsible for subsequent improvements in catastrophizing, but not vice versa. Together, these findings suggest improvements in catastrophizing during psychosocial intervention may prevent transition from acute to chronic pain after injury. Future research with larger between-person sample sizes, more frequent within-person assessment, and comparable control group data is necessary to facilitate greater understanding of psychosocial mechanisms for preventing chronic pain after injury. PERSPECTIVE: This study examines within-person relationships between pain catastrophizing and intensity during and after a four-session mind-body intervention to prevent persistent pain after acute traumatic orthopedic injury. Improved catastrophizing at post-test was associated with reduced pain with activity at three-month follow-up. Within-person analyses enhance understanding of psychosocial mechanisms for preventing chronic pain after injury., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024. Published by Elsevier Inc.)

Objective: Pain is a significant and debilitating symptom of rheumatoid arthritis (RA) that significantly affects the quality of life and functional ability of patients. In the present study, we examined the association between pain variables and disease activity markers in patients with RA., Methods: We enrolled 133 patients with RA and assessed their clinical characteristics, socioeconomic and psychological factors, and pain measures. The psychological factors assessed included depressive symptoms and pain catastrophizing., Results: The study cohort comprised predominantly female patients with RA with an average age of 55.5±10.1 years. Depressive symptoms had a mean score of 5.83±4.71, while pain catastrophizing had an average score of 14.36±10.70. The mean scores for pain intensity, and pain interference, were 2.98±1.75 and 19.54±16.17, respectively, with significant positive correlations observed with depressive symptoms. Hemoglobin and hematocrit levels were negatively correlated with pain intensity. Multivariable linear regression analysis revealed significant associations between depressive symptoms and pain intensity, catastrophizing, and interference. Other factors associated with pain intensity included tender joint count. Pain catastrophizing was associated with education and economic status. Pain interference was associated with sex and economic status., Conclusion: This study shows the influence of disease-related indicators and psychological factors on pain in patients with RA, with depressive symptoms playing a crucial role in predicting pain experience. Effective pain management strategies for RA should include the management of depressive symptoms, in addition to addressing disease-related indicators., Competing Interests: CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © 2025 by The Korean College of Rheumatology. All rights reserved.)

Aims: To investigate the relationships between parental resilience, illness perception and pain catastrophizing as factors affecting caregiver burden among parents of children with cancer, based on the Transactional Model of Stress and Coping., Background: Parents, as the primary caregivers of children with cancer, often face universal challenges. These include adverse health impacts, work, financial disruptions, strained social and family relationships, and the need for specialised support and intervention., Design: A cross-sectional design using path analysis., Methods: The STROBE guidelines for cross-sectional studies were followed. An online questionnaire was distributed through Facebook pages operated by various organisations that support parents of children with cancer, such as 'The Israel Cancer Association', 'Giving Hope' and 'Hayim Association' from October 2021 to February 2022. The participants completed a questionnaire about demographic and child-related characteristics, resilience, illness perception, pain catastrophizing, social support and caregiver burden. Associations between the variables were explored using Pearson's correlations and path analyses., Results: The study included 67 parents of children with cancer with an average age of 41.79 (SD = 6.31). The majority were mothers (n = 54, 80.6%) with a steady partner (n = 62, 92.5%). The level of caregiver burden was M (SD) = 25.00 (7.15) out of 48 possible, indicating a high burden level. Illness perception was directly positively associated with caregiver burden (β = .280, p = .017) and pain catastrophizing (β = .340, p < .01), and directly negatively with resilience (β = -.318, p < .01). Illness perception and pain catastrophizing serially mediated the relationship between resilience and caregiver burden among parents of children with cancer (β = -.190, p = .001)., Conclusions: This study found that both illness perception and pain catastrophizing serially mediated the relationship between personal resilience and caregiver burden., Relevance to Clinical Practice: To ease caregiver burden for parents of children with cancer, programmes should address their psychological and emotional needs, including managing perceptions of illness and coping with pain-related distress., (© 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Background: Endometriosis, characterized by the presence of endometrial-like tissue outside the uterus, results in chronic pelvic pain. However, lesion characteristics alone cannot fully explain the complexity of endometriosis-related pain. Pain catastrophizing, a cognitive process that influences pain perception, has traditionally been studied through cross-sectional or two-wave designs, which struggle to capture its dynamic interplay with endometriosis pain. To address these gaps, our study explores the bidirectional relationship between pain catastrophizing and pain outcomes-including intensity, frequency, and flares-over a detailed four-week period, an aggregated 30-day timeframe, and across sensory and affective dimensions., Methods: A Latent Growth Curve Model assessed the relationship between pain catastrophizing, initial pain levels, and endometriosis pain trajectories over four weeks. Additionally, four mediator models explored how baseline pain catastrophizing affects various pain aspects, including sensory and affective dimensions, and its subsequent influence on pain catastrophizing., Results: Results indicate that high levels of pain catastrophizing significantly escalate endometriosis pain over four weeks, affecting average pain intensity, episode frequency, and flares over 30 days. Pain catastrophizing also adversely impacts sensory and affective dimensions. These elements partially mediate baseline pain catastrophizing's effect on week five levels, revealing a bidirectional relationship. Notably, while the affective dimension amplifies subsequent pain catastrophizing, the sensory dimension exerts a contrasting negative influence., Conclusion: The study highlights the bidirectional influence between pain catastrophizing and several aspects of endometriosis-related pain. Sensory and affective dimensions play distinct roles, with implications for personalized interventions. Limitations and clinical relevance are discussed., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Greater unhelpful thinking is associated with greater musculoskeletal discomfort and incapability. Cognitive-behavioral therapy (CBT) fosters healthy thinking to help alleviate symptoms., Questions: In a meta-analysis of randomized control trials (RCT) of CBT for unhelpful thinking among people with musculoskeletal symptoms, we asked: 1) Does CBT reduce unhelpful thinking and feelings of distress, and improve capability, in individuals with musculoskeletal symptoms? 2) Are outcomes affected by CBT delivery methods?, Methods: Following QUOROM guidelines, we searched databases using keywords of pain catastrophizing, kinesiophobia, cognitive-behavioral therapy, musculoskeletal and variations. Inclusion criteria were RCT's testing CBT among people with musculoskeletal symptoms. Study quality was assessed with Cochrane Review of Bias 2. Meta-analysis of means and standard deviations was performed., Results: CBT led to modest reductions in catastrophic thinking (-0.44 CI: -0.76 to -0.12; P  = .01, kinesiophobia (-0.60 CI: -1.07 to -0.14; P  = .01) and anxiety symptoms (-0.23 CI: -0.36 to -0.09; P  < .01) over six months compared to usual care. There were no improvements in levels capability (-0.28 CI: -0.56 to 0.01; P  = .05). CBT led by mental health professionals reduced catastrophic thinking more than CBT led by other clinicians (QB Test = 4.73 P  = .03). There were no differences between online and in-person sessions, group versus individual therapy, or surgical versus non-surgical interventions., Conclusion: The evidence that CBT delivered by various clinicians in various settings fosters healthier thinking in people presenting for care of musculoskeletal symptoms, supports comprehensive care of musculoskeletal illness. More research is needed to develop indications and interventions that also improve levels of capability. Level-I, meta-analysis of RCT's., Competing Interests: Please separate ICMJE forms attached for each author details on conflicting interests., (© The Author(s) 2024.)

Migraine, marked by moderate to severe headaches, is frequently accompanied by reversible neurological symptoms. Recent studies have revealed a complex and significant relationship between psychological factors and the onset and progression of migraine. Personality traits, such as neuroticism and harm avoidance, play a crucial role in the development, progression, and treatment outcomes of migraines. Migraine patients often experience comorbid mental health conditions, such as depression and anxiety, which contribute to a diminished quality of life by exacerbating migraine-related disability and impaired occupational functioning. In particular, high levels of pain catastrophizing and anxiety sensitivity in migraine sufferers reflect their negative cognitive beliefs, which are closely linked to both their personality traits and vulnerability to mental disorders. This article explores the pathophysiological mechanisms underlying the relationship between migraine and psychological factors, including genetic influences, overlapping brain regions, 5-hydroxytryptamine (5-HT) dysfunction, and neurogenic inflammation. While traditional pharmacological treatments for migraine are often influenced by psychological factors and may have limited efficacy, psychotherapy, such as cognitive behavioral therapy and positive thinking therapy, has been increasingly recognized for its role in alleviating the psychological symptoms associated with migraine and enhancing overall therapeutic outcomes., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yu et al.)

Background/objectives: Variability in biopsychosocial factors can explain the interindividual variability in pain. One factor that can impact pain is the pain catastrophizing level. Interestingly, parental pain catastrophizing is related to the severity of the clinical pain of their children. This study explored whether parental pain catastrophizing is also associated with their children's experimental pain sensitivity., Methods: Forty-five healthy girls (mean age 12.07 ± 1.47 years) and one of their parents participated in this study. Parents completed the Pain Catastrophizing Scale (PCS) about their child's pain (PCS-Parent child ) as well as their pain (PCS-Parent). Children completed the PCS about their pain (PCS-Child) and the Pubertal Developmental Scale (PDS). Children underwent psychophysical tests, including paradigms of temporal summation, heat- and pressure-conditioned pain modulation, offset analgesia, and cold pain tolerance. Correlations and regression models were conducted to assess the relationships between parental pain catastrophizing scales (separately for PCS-Parent child and PCS-Parent) and experimental pain sensitivity with and without controlling for PCS-Child and PDS. T-tests were used to compare pain sensitivity between participants with vs. without a family history of psychiatric disorder., Results: No significant relationships were found between the experimental pain sensitivity measures and either PCS-Parent child or PCS-Parent with and without controlling for PCS-Child and PDS. No differences were found in experimental pain sensitivity between participants with and without a family history of psychiatric disorder., Conclusions: Parental pain catastrophizing may contribute minimally to the individual variability in experimental pain sensitivity of healthy adolescent girls.

Background/Objectives : Wrist/hand injury incidences in the general population are high and contribute to a significant health problem. Fear of pain from movement can impact physical recovery, contributing to prolonged disability and impaired function in an upper limb after wrist/hand injury. The study's objectives are (1) to evaluate the relationship between kinesiophobia, pain catastrophizing, Quick DASH, and Patient-Rated Wrist Evaluation and (2) to evaluate the data regarding the influence that basal kinesiophobia may have on upper limb functionality after wrist/hand immobilization. Methods : Participants referred from different medical centers with a wrist or hand injury that required immobilization were enrolled in the study. Data were collected just after the post-immobilization period. The following outcome measures were evaluated: the Quick DASH, the PRWE (Patient-Rated Wrist Evaluation), the TSK (Tampa Scale of Kinesiophobia), and the PCS (Pain Catastrophizing Scale). Demographics were summarized with descriptive statistics and linear relationships between variables using Pearson's correlation coefficient. Furthermore, multivariate linear regression analysis was performed to determine whether kinesiophobia could predict upper functional performance. Results : 64 patients (40 women, 24 men) participated in the study. Significant kinesiophobia positive correlations were found between the TSK and the Quick DASH ( r = 0.848, p < 0.001) as well as the TSK and the PCS error ( r = 0.521, p < 0.001). The regression model explains 30.4% of the variance in upper limb function, suggesting that the PRWE, the Pain Catastrophizing Scale, and the Quick DASH are important in predicting dysfunction. Conclusions : Kinesiophobia may contribute to but is not a significant predictor of dysfunction in this model.

The aims of the study are to analyze the influence of pain and no pain expectations on the physiological (electromyography (EMG) and pupillometry) and cognitive (Numerical Rating Scale (NRS)) response to pain. Pain expectation and no pain expectation situations were induced by employing instructional videos. The induction of pain was performed by palpating the masseter with an algometer in a sample of 2 groups: 30 healthy participants (control group) and 30 patients (Temporomandibular disorders (TMD) group) with chronic myofascial pain with referral in the masseter muscle (Diagnostic Criteria for Temporomandibular Dissorders (DC/TMD)). Used a mixed design all participants were exposed to pain and no pain conditions in the same session, but the order of the presentation was counterbalanced across participants to control its possible influence. A significantly larger pupillary diameter was observed in the pain expectation relative to the no pain expectation condition in both groups. The TMD group presented larger EMG activity and larger scores in anxiety, somatization, catastrophizing and central sensitization than the control group. In the NRS, the TMD group also showed a significantly higher score than the control group. The TMD group presented similar NRS scores in the expectation condition compared to the no pain expectation condition, while the control group presented higher scores for pain expectation than for no pain expectation. Pain expectation modulated the pain cognitive pain assessment and pupil diameter in controls. The cognitive pain assessment was altered in the TMD group compared to the control group, particularly in the no pain expectation condition, this may be due to a negative reappraisal of pain due to past experiences, as pointed out by the observed level of catastrophizing. Pain expectations did not influence the EMG, significantly higher EMG activity was found in the TMD group compared to the control group regardless of expectation type., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

Objective/aim: The aim was to compare the levels of physical activity, kinesiophobia, pain catastrophizing, body awareness, and depression in patients with Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA) and to explore the associations between these outcomes and disease activity., Methods: Seventy-eight patients with AS (n = 30) and RA (n = 48) were included. Outcomes were assessed using the International Physical Activity Questionnaire-Short Form, the Tampa Scale of Kinesiophobia, the Pain Catastrophizing Scale, the Body Awareness Questionnaire, and the Beck Depression Inventory. Disease activity levels were determined using the Bath Ankylosing Spondylitis Disease Activity Index for AS and the Disease Activity Score 28 score for RA., Results: AS patients were younger, had a higher proportion of men, and were more physically active than RA patients (p < 0.05). Both groups exhibited high levels of kinesiophobia but low levels of pain catastrophizing, similar body awareness and mild depression scores. Moderate correlations (r ≥ 0.5) were observed between kinesiophobia and depression, body awareness and pain catastrophizing and depression, and pain catastrophizing and disease activity in AS patients. In RA patients, moderate correlations (r ≥ 0.5) were found between kinesiophobia and pain catastrophizing., Conclusion: Addressing physical activity, kinesiophobia, pain catastrophizing, body awareness, and depression is important in managing AS and RA patients. Notably, correlations among outcomes differed between groups, with more significant correlations in AS. Further studies are needed to explore these in greater detail., (© 2024 John Wiley & Sons Ltd.)

Background and Purpose: When examining coping with chronic pain, it is important to consider not only the physical characteristics of pain but also its psychological and social aspects, such as depression or pain catastrophizing. The relationship between pain and the psychological characteristics of patients has been studied in various approaches in previous research. The aim of this study was to separate groups within a clinical sample using a profiling method and to identify risk factors related to illness behaviour., Methods: The study involved 136 patients aged 18 and above diagnosed with chronic pain of various etiologies. Data collection involved the use of psychological questionnaires measuring levels of health literacy, social support, depressive symptoms, and pain catastrophizing, in addition to pain characteristics. Statistical analysis of the data was conducted using independent samples t-tests, one-way ANOVA, and K-means cluster analysis., Results: Three clusters significantly different from each other in terms of all grouping variables (p < 0.001 in each case) were identified within the studied sample. These clusters were named “Conscious Worriers” (1st), “Balanced Symptom Perceivers” (2nd), and “Abandoned Catastrophizers” (3rd). We successfully identified the 2nd cluster as a protected group and the 3rd cluster as a risk group., Conclusion: Identified clusters can facilitate the application of group-specific pain therapies by describing the characteristic combinations of risk factors. Our results support the importance of pain education and prevention.

Objective: We examined the intersection between chronic pain stigma and racial discrimination, separately among Black and White U.S. adults with chronic low back pain., Methods: Participants completed measures of chronic pain stigma, lifetime experiences of racial discrimination, pain severity and interference. A composite variable representing the intersectionality of stigma and discrimination was created, and Black and White participants were separately categorized into 4 groups. Black participants were categorized as: 1) high discrimination/high stigma, 2) high discrimination/low stigma, 3) low discrimination/high stigma, and 4) low discrimination/low stigma. White participants were categorized as: 1) any discrimination/high stigma, 2) any discrimination/low stigma, 3) no discrimination/high stigma, and 4) no discrimination/low stigma., Results: Black participants reported more frequent experiences of racial discrimination than White participants (p<.05), but there was not a racial difference in chronic pain stigma (p>.05). Among Black participants, those in the high discrimination/high stigma and low discrimination/high stigma groups reported greater pain severity and interference than those in the high discrimination/low stigma and low discrimination/low stigma groups (p<.05). Among White participants, those in the any discrimination/high stigma group reported greater pain severity and interference than those in the no discrimination/low stigma group (p<.05), but there were no differences in pain severity or interference between the any discrimination/no stigma and no discrimination/high stigma groups (p>.05)., Conclusion: Our findings suggest that the relationship of intersectional chronic pain stigma and racial discrimination with pain is nuanced and differs across racial groups., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: The aim of this study is to clarify inconsistencies in the literature regarding the neuropsychological impact of chronic pain and determine how pain catastrophizing and pain intensity may explain cognitive impairment., Methods: This cross-sectional study involved 30 participants with chronic primary musculoskeletal pain and 30 healthy controls without pain. The instruments used were the Pain Catastrophizing Scale, the Visual Analogue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory-II, the Wisconsin Card Sorting Test, the Stroop Test, and the Working Memory Index of the Wechsler Adult Intelligence Scale., Results: Chronic pain patients showed slight cognitive impairments in selective attention, sustained attention, working memory, problem solving, planning, abstract reasoning, inhibition, and resistance to interference. The data also indicate that higher levels of pain catastrophizing and pain intensity were independently associated with greater cognitive impairment in patients with pain, specifically in attention and executive functioning. Additionally, the interaction between these pain-related variables predicted further cognitive impairment., Conclusions: This research has contributed to establishing the neuropsychological profile of patients with chronic primary musculoskeletal pain and reinforces evidence of the impact of chronic pain on cognition. These findings may help guide the design of programs aimed at improving cognitive performance.

Objectives: Pain catastrophizing is a core psychological factor determining pain experience. We addressed the question of whether patients with different pain syndromes group into different pain catastrophizing phenotypes., Methods: A total of 727 patients with chronic pain associated with four primary syndromes: Breast cancer (BC) survivors ( n = 400), fibromyalgia (FM, n = 52), complex regional pain syndrome (CRPS, n = 155), and HIV ( n = 120) were first studied for differences in levels of pain catastrophizing (Pain Catastrophizing Scale, PCS) and pain intensity by analysis of variance. Subsequently, individual scores of the PCS subscales "rumination", "magnification," and "helplessness" from the pooled cohorts were submitted to multivariate k-means clustering to explore subgroups., Results: Three clusters defined by the level of catastrophizing were identified. The "low catastrophizing" cluster ( n = 377) included most of the BC patients (71.0%) and the "moderate catastrophizing" cluster ( n = 256) most of the FM patients (61.5%). HIV (31.9%) and CRPS (44.7%) patients were over-represented in the "high catastrophizing" cluster ( n = 94) with the highest catastrophizing tendencies in all dimensions. These patients reported more helplessness than the patients in the two other clusters., Conclusions: The primary syndrome causing the pain has an impact on self-reported pain-related catastrophizing. Helplessness is a predominant feature in HIV and CRPS patients and therefore an important target in pain rehabilitation., (© 2024 the author(s), published by De Gruyter.)

Pain catastrophizing is a prominent psychological factor that is strongly correlated with pain. Although the complex properties of pain catastrophizing vary across different pain phases, the contribution of chronic pain to its progression from a general trait to a higher state remains unclear. This study aimed to examine the neural mechanisms and degree to which pain catastrophizing is reinforced in the context of primary dysmenorrhea (PDM), one of the most prevalent gynaecological complaints experienced by women of reproductive age. Altogether, 29 women with moderate-to-severe PDM were included in this study. Arterial spin labelling was used to quantify the cerebral blood flow (CBF) in each participant in both the pain-free and painful phases. The pain catastrophizing scale (PCS) was completed in two phases, and the Short-Form McGill Pain Questionnaire was completed in the painful phase. Compared with pain catastrophizing in the pain-free phase (PCS pf ), pain catastrophizing in the painful phase (PCS p ) is higher and positively correlated with the composite factor of menstrual pain. CBF analysis indicated that the PCS p is positively associated with CBF in the frontal cortex, hippocampus and amygdala. The reinforcement of pain catastrophizing correlates with CBF in the prefrontal cortex. Specifically, the medial prefrontal cortex, which correlates with pain state, plays a crucial role in mediating the reinforcing effect of pain in the PCS p . These results promote the mechanical comprehension of pain catastrophizing management in individuals with chronic pain., (© 2024 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Objectives: Tactile acuity is a somatosensory measure of the extent to which humans can discern tactile stimuli. It is influenced by how peripheral signals are processed centrally. In the oral cavity, Occlusal Tactile Acuity (OTA) is the ability to perceive minimal thicknesses between antagonist teeth. The aim of the current study was to assess the association between psychological traits and OTA of otherwise healthy individuals., Methods: Sixty-three volunteers (32 males; mean age ± SD: 24.6 ± 2.7 years) participated in this study. Somatosensory amplification, anxiety, depression, physical symptoms and pain catastrophizing were scored using questionnaires, and subgroups of severity were created per variable based on cut-offs. OTA was measured using 9 aluminium foils with thickness (ranging from 8 to 72 μm) and one sham test (without foil). Each thickness was tested 10 times in random order, the participants were instructed to report whether they felt the foil between their molars and the mean percentage of correct answers was computed. A linear mixed model was used with OTA as a dependent variable and psychological domain as an independent variable., Results: Significantly different OTA was observed among the anxiety subgroups (p = .003), supporting a decreased perception of thicknesses 24 and 32 μm (p = .018 and p < .001, respectively) in participants with moderate/severe anxiety compared to those with no/mild anxiety. Significantly different OTA was also observed among the pain catastrophizing subgroups (p = .008), showing decreased perception of thicknesses 32 and 40 μm (p < .001 and p = .007, respectively) in severe catastrophizing levels, compared to no/mild catastrophizing levels. No significant differences were observed for the other variables., Conclusions: Healthy adults with increased anxiety or pain catastrophizing levels show decreased interdental acuity as compared to participants with minor or no psychological impairment., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Objective: To examine the phenomenon of pain catastrophizing among the principal caregivers of postoperative children with malignant bone tumors and explore its impact on pain perception and kinesiophobia in children., Design: A cross-sectional study design., Methods: Using a cross-sectional study design, a questionnaire-based survey was conducted among 140 children with malignant bone tumors and their principal caregivers, who were admitted to a tertiary hospital in Shanghai from 2020 to 2023. Pearson's univariate and multiple regression analyses were conducted. The questionnaire included general data, the Parental Pain Catastrophizing Scale, the Short-Form McGill Pain Questionnaire, and the Tampa Scale of Kinesiophobia., Results: The frequency of pain catastrophizing for the principal caregivers was 16.8%. The frequency of kinesiophobia in children was 93.1%. The level of pain catastrophizing was positively correlated with the level of kinesiophobia and pain perception (r = 0.556, 0.614, p < 0.05). Multiple logistic regression analysis showed that the level of pain catastrophizing in principal caregivers was an important factor of kinesiophobia in children (B = 0.370, Std. = 0.119, Wald = 9.687, Ex (P) = 1.448, p = 0.002). Multiple linear regression analysis showed that the incidence of pain catastrophizing and the level of kinesiophobia were important influencing factors in pain perception (p < 0.05), with R 2  = 0.272, adjusted R 2  = 0.249, F = 11.579, and p < 0.001., Conclusions: The level of pain catastrophizing in the principal caregivers was an important factor in postoperative kinesiophobia and pain perception in children with a malignant bone tumor., Practice Implications: It is important to evaluate the patients' and their families' emotional changes and psychological needs during the perioperative period. Nurses play a crucial role in providing appropriate interventions for patients or families to reduce the negative pain experience and improve patients' prognosis., Competing Interests: Declaration of competing interest The authors declare no financial or other relationships that might lead to a conflict of interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In temporomandibular disorder (TMD), the effects of standard interventions such as using an occlusal splint and its impact on pain relief and pain catastrophizing are poorly understood. Earlier work pointed to a crucial role of insula activation with changes in pain relief by occlusal splint treatment. We performed a functional imaging study using specially developed splint systems to allow for a placebo-controlled longitudinal design. Using functional MRI we examined 20 TMD patients during repetitive occlusal movements at baseline and over the course of splint therapy and also collected self-reported pain catastrophizing. For balancing performance between baseline and after intervention we used occlusion force measures in an individualized fMRI-splint system. Splint therapy lasted for approximately 7 weeks with one group selected by randomization wearing a palatine placebo splint over the first 3 weeks (delayed start; 11 individuals). As expected, fMRI activation in areas involved in pain processing (insula, primary and secondary somatosensory cortex) decreased with intervention. At baseline a positive correlation between activation of the left anterior insula and pain catastrophizing was present. Both parameters decreased over intervention while associations were primarily observable for patients with rather mild TMD., (© 2024 The Author(s). Human Brain Mapping published by Wiley Periodicals LLC.)

Background: Mindfulness-based treatments gained popularity for migraine treatment. In this manuscript we report the results of a single-arm open pilot study that evaluated the impact of a multimodal web-based intervention combining home-based medication withdrawal, patients' education, and online mindfulness-based interventions. We aimed to address whether our program had the ability to show a change in the observed parameters and the study should therefore be intended as an early phase trial., Methods: Consecutive patients with chronic migraine associated with medication overuse headache were enrolled, followed-up for 12 months, in a program that included home-based medication withdrawal, education on the correct use of drugs and lifestyle issues, prescription of tailored pharmacological prophylaxis, and attendance to six online mindfulness-based sessions. We tested the effect of the program on improving headache frequency, medication intake, quality of life (QoL), headache impact, depression, self-efficacy, and pain catastrophizing., Results: A total of 37 patients completed the study (10 dropped out). We observed a large improvement in headache frequency, medication intake, headache impact, and QoL, a moderate improvement in pain catastrophizing and a mild improvement in depression symptoms; 70% to 76% of patients achieved 50% or more reduction in headache frequency from baseline to each follow-up (p < .01)., Conclusions: The results of our multimodal program showed significant improvements in headache frequency, medication intake, and patient-reported outcomes. Future studies are needed to better identify patients who might benefit most from Digital Health Interventions and to demonstrate at least an equivalence in outcome with in-person programs carried out in hospital settings., (© 2024. Fondazione Società Italiana di Neurologia.)

Background: Total knee arthroplasty is associated with an inflammatory response and high levels of pain in a subset of patients. Pain catastrophizing has been associated with acute postoperative pain. The association between these variables has not been investigated in an optimised fast-track setup including preoperative glucocorticoids. The aim of this study was, first, to investigate the correlation between the increase in postoperative c-reactive protein (CRP) and acute postoperative pain after total knee arthroplasty, and second, to investigate the correlation between the increase in CRP and preoperative pain catastrophizing., Methods: This study is a secondary analysis of data from 119 patients participating in two randomised controlled trials. Correlation analyses were performed for preoperative CRP and CRP increase at 24 and 48 h and pain during a well-defined mobilisation at 24 and 48 h after total knee arthroplasty. Additionally, correlation analyses were performed between CRP increase and pain catastrophizing using the pain catastrophizing scale., Results: There was no correlation between preoperative CRP or postoperative CRP increase and pain at both 24 and 48 h. Analyses were similar when separated into high and low pain catastrophizers. There was no correlation between preoperative CRP or postoperative CRP increase and pain catastrophizing., Conclusion: There was no association between the postoperative CRP response and postoperative acute pain or pain catastrophizing in patients undergoing total knee arthroplasty in a well-defined multimodal fast-track regime including preoperative glucocorticoids. These results suggest that acute pain after knee arthroplasty is not reflected by CRP when applying preoperative glucocorticoids., (© 2024 Acta Anaesthesiologica Scandinavica Foundation.)

Purpose: This study aimed to investigate the correlation between preoperative pain catastrophizing and social support, and acute post-surgical pain in patients who underwent knee arthroplasty. The study also aimed to determine whether social support moderates the role of pain catastrophizing psychologically in acute post-surgical pain after knee arthroplasty., Patients and Methods: This study recruited participants to survey a tertiary hospital in Dalian, China, between November 2022 and October 2023. Participants completed pain catastrophizing scales and social support reevaluated scales one day (T1) before they were confirmed to undergo knee arthroplasty, and finished the Numeric Rating Scale at 24h (T2), 48h (T3), and 72h (T4) postoperatively. Pearson correlation analyses were used to explore the relationship between social support, pain catastrophizing, and acute post-surgical pain, hierarchical regression analysis was used to test the moderating role of social support between pain catastrophizing and acute post-surgical pain., Results: This study recruited 178 knee arthroplasty patients. The results of the t -test or one-way ANOVA indicated that there were statistically significant differences in gender, age, education, occupation, disease duration, whether the knee replacement was performed for the first time, preoperative pain scores, and operation time in patients with knee arthroplasty ( P < 0.05). The correlation analysis of social support, pain catastrophization, and acute post-surgical pain in knee arthroplasty patients showed that social support was negatively correlated with acute post-surgical pain ( r =-0.584, P <0.01), and pain catastrophizing was positively correlated with postoperative acute pain ( r =0.601, P <0.01); The hierarchical regression analysis revealed that social support had a significant moderating effect on the relationship between pain catastrophizing and acute post-surgical pain ( ΔR2 =0.606, P <0.05)., Conclusion: The acute post-surgical pain of knee arthroplasty patients was affected by gender, age, education, occupation, disease duration, whether the knee arthroplasty was performed for the first time, preoperative pain scores, and operation time. Acute Post-surgical pain in patients with knee arthroplasty was affected by social support and pain catastrophizing, and social support had a moderating effect on the relationship between pain catastrophizing and acute post-surgical pain., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Ai et al.)

Introduction: Knowledge about long-time residual symptoms, disabilities, and psychological health in complex regional pain syndrome (CRPS) is limited., Objectives: The aim was to evaluate outcome, focusing on physical symptoms, disability, and psychological health, in individuals with CRPS through a cross-sectional survey study., Methods: Individuals with a confirmed diagnosis of CRPS were identified through medical charts and sent validated survey forms (Disabilities of the Arm, Shoulder and Hand-Quick version, Specific Hand Surgery Questionnaire-8 questions, EuroQol 5 Dimensions 3 levels, Life Satisfaction Questionnaire-11, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, and Sense of Coherence-29) and complementary questions., Results: Responders (response rate: 99/238, 42%; CRPS type 1: 72%; CRPS type 2: 28%; time since diagnosis median: 59 [34-94] months) reported remaining symptoms and disability (Disabilities of the Arm, Shoulder and Hand-Quick version score: 45 [20-70]) and more improvement in type 1 than in type 2. Only 9% of individuals with CRPS reported no residual pain or discomfort. Approximately 60% had problems in daily activities, 49% had sleeping problems, and 90% experienced moderate-extreme pain with 23% still on sick leave. The Hospital Anxiety and Depression Scale survey revealed significantly higher scores than a Swedish reference population. Individuals with a low Sense of Coherence and high pain catastrophizing had worse disability and were less satisfied with their lives and physical and psychological health. A lower level of education and more anxiety were associated with worsened disability over time., Conclusion: Individuals with CRPS suffer in the long term from pain, sleeping problems, and limitations in daily activities with occurrence of anxiety and depression, resulting in dissatisfaction with many aspects of their lives. A low Sense of Coherence and high pain catastrophizing are associated with a worse outcome. Biopsychosocial aspects should be addressed in clinical practice., Competing Interests: The authors have no conflicts of interest to declare. This work was supported by grants from the Swedish Research Foundation (grant number 2021-01942), Lund University, the Swedish Diabetes Foundation (DIA2020-492), Funds from Skåne University Hospital (2022-974), and by ALF Grants in Region Skåne, Region Östergötland (register number RÖ978765 and RÖ985138), Sweden, and Elly Olsson's Foundation for Medical Research. The complete and detailed individual data of all subjects cannot be publicly available for ethical and/or legal reasons due to compromising patient privacy based on Swedish law. The National Ethical Committee (https://etikprovningsmyndigheten.se/en/) has imposed these restrictions. Data can be obtained after application and approval of the research project by the National Ethical Committee (https://etikprovningsmyndigheten.se/en/) and by the data safety committees of the regional health care system in Region Skåne, Sweden (KVB-decision; https://vardgivare.skane.se/kompetens-utveckling/forskning-inom-region-skane/utlamnande-av-patientdata-samradkvb/) and in Region Östergötland, Linköping, Sweden., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.)

Background: Chronic pain and inflammation are common features of rheumatic conditions such as Psoriatic Arthritis (PsA) and Axial Spondyloarthritis (axSpA), often needing prolonged medication treatment for effective management. Maintaining drug retention is essential for both achieving disease control and improving patients' quality of life. This study investigates the influence of pain catastrophizing, a psychological response to pain, on the drug retention rates of PsA and axSpA patients., Methods: A two-year prospective multicenter observational study involved 135 PsA and 71 axSpA patients. Pain Catastrophizing Scale (PCS) was employed to assess pain catastrophizing. Univariable and multivariable regression analyses were utilized to identify factors associated with drug retention., Results: In the PsA group, patients early discontinuing therapy showed higher baseline disease activity as well as higher incidence of comorbid fibromyalgia. Notably, pain catastrophizing, specifically the domains of Helplessness, Magnification, and Rumination, were significantly elevated in PsA patients who interrupted the treatment. Multivariable analysis confirmed pain catastrophizing as an independent predictor of drug suspension within two years. In axSpA, drug discontinuation was associated with female gender, shorter disease duration, higher baseline disease activity as well as elevated levels of pain catastrophizing. Univariable analysis supported the role of pain catastrophizing, including its domains, as predictors of treatment interruption. However, limited events in axSpA patients precluded a multivariate analysis., Conclusion: This prospective study emphasizes the impact of pain catastrophizing on drug retention in patients with PsA and axSpA., (© 2024. The Author(s).)

Background: Kinesiophobia is common in patients after total knee arthroplasty and is an important risk factor for post-operative recovery outcomes. Little is known about the complex intercorrelations between different components of pain catastrophizing, self-efficacy, and kinesiophobia. This study aimed to identify the central components of kinesiophobia and to explore the interconnectedness between components of pain catastrophizing, self-efficacy, and kinesiophobia., Methods: A total of 216 patients after total knee arthroplasty were recruited in this study. Pain Catastrophizing Scale, Self-efficacy of Rehabilitation Outcome Scale and Tampa Scale for Kinesiophobia were used to assess pain catastrophizing, self-efficacy and kinesiophobia. R software was used to visualize the networks and analyze the centrality of the networks. The index "strength" and "bridge expected influence" were employed to identify the central components and the bridge components of the networks., Results: In the item network of kinesiophobia, three items ("Simply being careful that I do not make any unnecessary movements is the safest thing I can do to prevent my pain from worsening", "My accident has put my body at risk for the rest of my life", and "My body is telling me I have something dangerously wrong") had the highest strength centrality. In the pain catastrophizing/self-efficacy-kinesiophobia network, rumination had the highest positive bridge expected influence, while coping self-efficacy had the highest negative value., Conclusion: The three central components of kinesiophobia identified in this study, as well as two bridge variables (rumination and coping self-efficacy), could be promising and effective targets for prevention and intervention of kinesiophobia., Competing Interests: The authors have no relevant competing interests to disclose in this work., (© 2024 Zhou et al.)

Introduction: Pain catastrophizing describes helplessness, rumination, and magnification of a pain experience. High pain catastrophizing is an independent risk factor for disability, pain severity, inadequate treatment response, chronicity, and opioid misuse. Interdisciplinary pain programs (IPPs) are beneficial and cost-effective for individuals with chronic pain, but their functional impact on individuals with high pain catastrophizing is not well established. The emerging field of placebo studies suggests that patient-provider relationships, positive treatment expectations, and sociobiologically informed care trigger physiological responses that may enhance therapeutic interventions., Methods: In this retrospective observational cohort study, we compared admission and discharge data for 428 adults with high-impact chronic pain (mean 8.5 years) who completed the Spaulding-Medford Functional Restoration Program (FRP). The interdisciplinary FRP team of physiatrists, behavioral health clinicians, physical therapists, and occupational therapists specializes in evidenced-based conventional rehabilitation, integrative health, and pain psychoeducation via enriched therapeutic encounters, fostering collaboration, validation, trust, self-efficacy, and positive expectations. Clinical outcome measures included the Canadian Occupational Performance Measure (COPM) assessing functional performance (COPM-PS) and satisfaction with function (COPM-SS), the Pain Numeric Rating Scale (NRS), the Pain Catastrophizing Scale (PCS), and the Patient Health Questionnaire-9 (PHQ-9)., Results: FRP participants with clinically elevated catastrophizing at baseline (PCS ≥30, mean PCS 39) achieved statistically significant improvements in function (mean delta -2.09, CHI2 = 15.56, p  < 0.001), satisfaction with function (COPM-SS mean delta -2.50, CHI2 = 7.42, p  = 0.007), pain (NRS mean delta 2.7), mood (PHQ-9 mean delta 1.87, p  = 0.002), and catastrophizing (PCS mean delta 4.16, p  < 0.001). Subgroup analysis revealed racial disparities in pain scores, and exploratory analysis showed a trend toward reducing opiate consumption., Discussion: Despite the known association of adverse outcomes with high catastrophizing, FRP participation was associated with increased productive engagement, reduced pain, reduced maladaptive thought processes, and improved mood. Although causation and efficacy cannot be established from a retrospective design, this is the first study to identify functional improvement in patients with high-impact chronic pain and clinically relevant high pain catastrophizing who participate in an IPP combining conventional and complementary rehabilitation with psychoeducation. These enriched therapeutic encounters may enhance the treatment process by promoting trust, empathy, collaboration, and beneficial reframing of patients' experiences, expectations, and goals., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Vora, Kennedy-Spaien, Gray, Estudillo-Guerra, Phillips, Mesia-Toledo, Glenn, Chin and Morales-Quezada.)

The relationship between adaptive pain-coping skills, such as John Henryism, and pain and function remains unclear in non-Hispanic Black populations. This cross-sectional, observational study included sixty older Black men with low back pain in Jacksonville, Florida. Key measures were: self-reported 0-10 pain intensity in the past 24 h, 13-item pain catastrophizing, functional performance from the Back Performance Scale, and the John Henryism Active Coping Scale. Structural equation modeling was applied to 57 complete cases for analysis using R v4.2.0. There was a significant association for both John Henryism (β = -0.320, p = .038) and pain catastrophizing (β = 0.388, p = .007) with pain intensity but not functional performance (β = -0.095, p = .552; β = 0.274, p = .068, respectively) in the older Black men. The study underscores the future importance of evaluating John Henryism using longitudinal methods to explore causality with complex structural equation models among Black Americans., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

This study aimed to determine whether the relationship between pain resilience and pain catastrophizing in older patients after total knee arthroplasty (TKA) was mediated by cognitive emotion regulation strategies (CERS) and pain management self-efficacy (PMSE). Convenience cluster sampling was used in this cross-sectional study to recruit 382 older adults. The results revealed that pain catastrophizing was negatively correlated with pain resilience, adaptive CERS, and PMSE; however, it was positively correlated with maladaptive CERS (all p < 0.01). Mediation analysis revealed that both CERS (adaptive and maladaptive) and self-management independently and sequentially mediated the relationship between pain resilience and pain catastrophizing in older patients who underwent TKA. These findings demonstrate that CERS (adaptive and maladaptive) and PMSE play chain-mediating roles in the correlation between pain resilience and pain catastrophizing in older patients after TKA., Competing Interests: Declaration of competing interest The authors report no conflicts of interest in this work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Pain catastrophizing has been linked to amplified pain sensitivity assessed using quantitative sensory testing (QST) in adults; pediatric data are limited, particularly in youth with functional abdominal pain (FAP). With increasing use of QST to evaluate somatosensory function and predict pain outcomes, we examined the associations between QST and clinical pain in adolescents with FAP and tested the moderating effects of pain catastrophizing. Seventy-seven adolescents (mean age 16.6 years, 85.7% female, 72.7% White, 90.8% non-Hispanic) who fulfilled diagnostic criteria for FAP completed QST assessment (pressure pain threshold and tolerance, heat pain threshold, conditioned pain modulation) and measures of abdominal pain intensity, pain interference, and pain catastrophizing. Adjusting for age and sex, only higher heat pain threshold was associated with higher abdominal pain intensity (Beta per 1-standard deviation = .54, P = .026). Contrary to hypothesis, for youth with higher pain catastrophizing, higher pressure pain tolerance was associated with greater abdominal pain intensity, but associations were not significant for youth with lower catastrophizing (P = .049). Similarly, for those with higher pain catastrophizing (in contrast to lower pain catastrophizing), higher pressure pain thresholds and tolerance were associated with higher pain interference (P = .039, .004, respectively). Results highlight the need to investigate the influence of pain catastrophizing on QST. PERSPECTIVE: This study demonstrated unexpected findings of pain catastrophizing moderating the relationships between pressure pain threshold and tolerance, and clinical pain in adolescents with FAP. This raised questions regarding our understanding of psychological contributions to QST findings in pediatric populations with chronic pain., (Copyright © 2024 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Pain catastrophization (PC) is related to motor control changes in individuals with nonspecific chronic low back pain (NSCLBP). However, differences in dynamic balance control based on the level of PC still remain unclear in these individuals., Objective: The aim of this study was to compare the dynamic balance control between healthy controls and individuals with NSCLBP with high and low PC., Methods: Forty individuals with NSCLBP and 20 healthy participants were enrolled in this cross-sectional study. Individuals with NSCLBP were classified into two groups of high and low PC. Dynamic balance control was assessed using the Modified Star Excursion Balance Test (MSEBT), Five-Time Sit-to-Stand Test (FTSST), and Timed Up and Go Test (TUGT)., Results: Statistical analyses showed that mean values of reach distances in the anterior, posteromedial, and posterolateral directions of the MSEBT were significantly lower in individuals with NSCLBP with high PC compared to low PC ( p  = .04, p  = .01, and p  = .04, respectively) and healthy controls ( p  < .001, p  = .001, and p  = .006, respectively). In addition, for both the FTSS and TUG tests, the mean time was significantly greater in individuals with NSCLBP with high PC compared to low PC ( p  < .001 and p  = .004, respectively) and healthy controls ( p  < .001)., Conclusions: Our results showed poor dynamic balance control in individuals with NSCLBP with high PC. This suggests that PC could contribute to the impaired dynamic balance control in individuals with NSCLBP. Combining balance exercises and cognitive-behavioral treatments targeting PC may be useful for the improvement of dynamic balance control in individuals with NSCLBP with high PC.

According to evolutionary psychologists, an individual-consciously or not-who allocates resources for somatic effort focuses on homeostasis and the protection of themselves and others. During health crises, patients must choose between mobilizing their remaining resources to either recover or accepting the disease as inevitable. When patients choose to be proactive in terms of protecting their health, are conscientious, and compliant in the recovery process, a high level of patient activation is achieved. Therefore, we examined ( N = 252) whether the patients' K fitness strategies are predictors for engagement in patient activation-type behavior. In addition, we tested the mediating effect of pain catastrophizing and the moderating effect of romantic satisfaction. We found that people with a medical diagnosis, who were in a romantic relationship, and had high- K fitness were much more likely to be activated patients. Moreover, pain catastrophizing mediated the relationship between high- K fitness strategy and patient activation, while romantic satisfaction moderated this relationship, amplifying its intensity. The findings highlight the importance of identifying patients' psychological resources (e.g., high- K strategy, romantic satisfaction, or pain perception) to keep them engaged in the health recovery process., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Ene, Burtaverde, Jonason, Brehar and Pruna.)

Acute postsurgical pain (APSP) is an important risk factor for pain chronification, with reports of being more intense after total knee arthroplasty (TKA) than after total hip arthroplasty (THA). Psychological variables have been associated with differences in postsurgical pain experience. This study aimed to analyse the longitudinal reciprocal association between pain and anxiety levels in patients undergoing TKA or THA, to investigate the moderator role of the type of surgery and to explore psychological mediators in the anxiety - pain association. Patients undergoing TKA ( n = 120) or THA ( n = 109) were evaluated before surgery and in the acute postsurgical period (48 h postsurgery). Presurgical assessment comprised sociodemographic, pain-related and psychological variables (anxiety, depression, pain catastrophizing, self-efficacy, optimism and satisfaction with life). Postsurgical assessment focused on pain frequency, pain intensity and anxiety. Longitudinal associations were explored using cross-lagged panel models that included the indirect effect paths through possible mediators (pain catastrophizing and depression). Multigroup analyses compared TKA and THA. In the global sample, higher APSP was predicted by higher presurgical pain and worse presurgical anxiety. Multigroup analyses revealed that worse APSP was predicted by higher presurgical anxiety in patients undergoing TKA and by higher presurgical pain in patients undergoing THA. Furthermore, there was a positive significant indirect effect of pain catastrophizing, but not depressive symptoms, in the relationship between presurgical anxiety and APSP in THA. Anxiety and APSP are differently interrelated in TKA and THA. Psychological characteristics could be managed before surgery to favour better APSP control and potentially prevent pain chronification after total joint arthroplasty., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2024.)