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Pain Catastrophizing and Negative Mood States After Spinal Cord Injury: Transitioning From Inpatient Rehabilitation Into the Community

  • Ashley Craig
    Correspondence
    Address reprint requests to Professor Ashley Craig, PhD, John Walsh Centre for Rehabilitation Research, Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, Corner Reserve Road & First Avenue Royal North Shore Hospital, St Leonards NSW 2065, NSW 1680, Australia.
    Affiliations
    John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia
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  • Rebecca Guest
    Affiliations
    John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia
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  • Yvonne Tran
    Affiliations
    John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia

    Key University Centre for Health Technologies, University of Technology Sydney, Broadway, New South Wales, Australia
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  • Kathryn Nicholson Perry
    Affiliations
    Australian College of Applied Psychology, Sydney, New South Wales, Australia
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  • James Middleton
    Affiliations
    John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia
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      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.

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