Highlights
- •Pain catastrophizing is a serious problem for adults with acute spinal cord injury.
- •Catastrophizing is more likely in those who are depressive and anxious.
- •Risk of catastrophizing is greatest after discharge into the community.
- •Multiple factors contribute to risk of catastrophizing.
Abstract
Chronic pain is prevalent in people with spinal cord injury (SCI). We investigated
how chronic pain intensity and catastrophizing varies in adults with SCI during inpatient
rehabilitation up to 12 months postinjury after transitioning into the community.
Eighty-eight participants with SCI were assessed for pain intensity and catastrophizing,
depressive mood states, and cognitive performance. Participants were divided into
subgroups of clinically elevated depressive mood and anxiety versus those with normal
mood state levels. The rate of clinically elevated pain catastrophizing was 22.5%
at 12 months postinjury. Participants with elevated anxiety reported significantly
higher pain intensity 12 months postinjury. Participants with clinically elevated
depressive mood and anxiety reported significantly elevated pain catastrophizing 12 month
postinjury. Findings indicate those with elevated depressive mood states will be more
likely to have high levels of pain and engage in cognitive appraisals involving pain-related
catastrophizing. Importantly, however, risk of increased pain intensity and catastrophizing
occurred only after transitioning into the community, when personal resources will
be severely challenged. Implications of these results for models of pain catastrophizing
are discussed and it is concluded there is a need for ongoing support in the community
to develop self-management skills and strategies that strengthen social support networks.
Perspective
We studied pain catastrophizing and negative mood states in adults with SCI. Catastrophizing
was higher in those with depression, but only after discharge from hospital into the
community. Results provide direction for improving treatment of pain catastrophizing
in adults with SCI who are depressive and anxious.
Key words
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Article info
Publication history
Published online: March 05, 2017
Accepted:
February 15,
2017
Received in revised form:
February 1,
2017
Received:
December 29,
2016
Footnotes
This research was supported by a competitive grant from the Lifetime Care Support Authority (New South Wales, Australia): LTCSA 08/209.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society
