Highlights
- •Catastrophizing (CAT) in sickle cell disease (SCD) was assessed using 3 distinct pain referents.
- •SCD-specific CAT was greater than non-SCD or laboratory pain-related CAT.
- •SCD-specific and non-SCD CAT were associated with clinical pain.
- •Situational CAT was associated with central sensitization markers and laboratory pain.
- •Changes in situational CAT predicted later changes in laboratory pain sensitivity.
Abstract
Catastrophizing is a potent psychological modulator of pain across several chronic
pain populations; yet despite evidence that patients with sickle cell disease (SCD)
catastrophize more than patients with other chronic pain conditions, previous research
indicates that catastrophizing is not related to sickle cell pain after controlling
for relevant covariates such as depression. Recent research suggests that pain-related
catastrophizing should be assessed across pain contexts (eg, dispositional and situational).
In this study, we measured disease-specific, general non-disease-related, and situational
catastrophizing and assessed the relationship between these contextual dimensions
of catastrophizing and laboratory and clinical pain among patients with SCD. Results
revealed differential catastrophizing across pain contexts, with patients reporting
greater catastrophizing about SCD-specific pain compared with non-SCD pain and laboratory
pain. SCD-specific and non-SCD catastrophizing were associated with clinical pain
outcomes, and situational catastrophizing with markers of central sensitization and
laboratory pain. Further examination of the time course of laboratory responses revealed
that increases in situational catastrophizing were associated with subsequent increases
in laboratory pain sensitivity. Taken together, results show the relevance of catastrophizing
in understanding pain in SCD, and suggest that context-specific anchors may be beneficial
in predicting different aspects of the pain experience (eg, chronic pain, pain sensitization).
Perspective
Patients with SCD report greater catastrophizing about sickle cell-specific pain relative
to other pains. Disease-specific and non-disease-related pain catastrophizing were
associated with clinical pain, and situational catastrophizing predictive of subsequent
laboratory pain. Evaluation of context-specific catastrophizing may more accurately
predict different aspects of the pain experience.
Key words
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Article info
Publication history
Published online: August 21, 2016
Accepted:
August 10,
2016
Received in revised form:
June 28,
2016
Received:
April 14,
2016
Footnotes
This research was supported by the National Institutes of Health R01HL98110 (J.A.H.) and T32 NS070201 (V.A.M.).
S.L. has received research funds unrelated to this project from Pfizer, Selexys, Prolong, and Astra Zeneca and is a consultant for Apopharma and Global Blood Therapeutics. The remaining authors have no conflicts of interest to declare.
Identification
Copyright
© 2016 by the American Pain Society
