Causes of and Treatment for Pain Catastrophizing

Although a recent study indicates that treatment with SSRI antidepressants may help, CBT remains the primary form of therapy.

Medical experts used to believe that pain level depends on the amount of tissue damage, but it is now known that how much pain a person experiences depends on many factors. And it may depend as much on psychosocial factors as it does on physiology. 

The term ‘pain catastrophizing’ was first used to describe a maladaptive style of coping with pain that people with anxiety and depression used. 

Although pain catastrophizing may coexist with these conditions, pain catastrophizing also exists independent of these conditions.1

Defining Pain Catastrophizing

“Pain catastrophizing can be defined as a maladaptive coping style that includes hopelessness, expanded rumination, and pain magnification,” said Claudia M. Campbell, PhD, associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine in Baltimore, Maryland.

These three components of catastrophizing are captured in the Pain Catastrophizing Scale (PCS), which is often used to screen for pain catastrophizing. The PCS includes these assessments:

When I am in pain:

  • I can’t stop thinking about how much it hurts.
  • I worry something bad might happen.
  • There’s nothing I can do to reduce the intensity of the pain.

“It is hard to say how common pain catastrophizing is. To some extent, it is expected in people with pain. It is rare to have no catastrophizing, common to have some, but uncommon to have lots of catastrophizing. It may depend on the type of pain and how threatening it is,” explained Steven Z. George, PhD, associate professor of physical therapy at the University of Florida in Gainesville.

This article originally appeared on Clinical Pain Advisor