Catastrophization of pain, what is exactly

Pain catastrophization is a negative mental construct during the painful, real or anticipated experience.

Pain plays an important role, since it accounts for an injury or an disease in the body. Through acute pain it is possible to infer the location, nature and severity of a physiological alteration.

However, many factors can make pain experience chronic, which makes pain no longer have the usefulness of being an indicator of an injury, but causes a mismatch in the physical, cognitive and emotional balance of a person.

In a model proposed by Melzack and Casey el pain is conceptualized as a construct composed of three dimensions that are part of the painful experience: a sensory-discriminative, a cognitive-evaluative and an affective-motivational, the latter related to reflective processing that includes the meaning of pain in life. In this dimension there is also depression, anxiety, anger, frustration and fear related to the experience of pain.

Catastrophization of pain and lack of acceptance

The Pain catastrophization is an exaggerated mental construct and negative that is revealed in the experience of real or anticipated pain to it. It is considered one of the factors of the relationship between pain and emotional anguish.

In chronic pain, catastrophization has been related to more frequent episodes of pain, an impact on daily activities and work disability, More sensitivity to pain, depression, lower adhesion to pharmacological treatments, Suicidal ideation, longer rehabilitation periods after surgical interventions and others.

In 1995 Sullivan and other authors developed a scale for pain catastrophing and is one of the instruments that are most used to measure it. It has translated into several languages ​​and is part of the rehabilitation protocol in many pain clinics and rehabilitation centers.

Pain catastrophization not only leads to higher levels of pain and a lower response to treatment, but also increases the possibility that the condition continues for a longer period.

Pain catastrophization is also defined as an emotional and cognitive orientation, excessively and negatively towards pain, whether real or anticipated.

Is a tendency to focus excessively in painful sensation, exaggerating the damage and perceiving unable to control pain. Therefore, it has also been defined as a set of emotional and cognitive processes that contemplate the rumination of pain, the magnification of symptoms and feelings of hopelessness. It is characterized by attention in painful physical sensations and the interpretation of damage, real or potential.

Rumitations, the habit of thinking too much

Some authors have associated catastrophing, such as Maladaptative coping, with an increase in inflammatory activity and with reduction in muscles force. It has also been suggested that pain catastrophing depends on the type of pain and that, in addition, can change throughout life, being different in young adults - which is mostly emotional - and in older adults.

Among the negative psychological variables associated with catastrophization is the severity of pain, negative mood, psychological stress and poor physical functioning.

Pain -related fear It has been considered as a factor that leads to avoidance, which, in turn, is associated with other symptoms such as high pain intensity, more physical impediments, depression and permanent disability. According to a hypothesis, Greater pain, more fear, more avoidance, more catastrophization and greater pain.

On the other hand, among the positive variables is acceptance, which seems to reduce the negative effects of pain, since it is related to lower depression, anguish, lower disability and more functionality. Acceptance is defined as a stage in which an agreement with pain is reached, The objectives of life are rebuilt and pain is integrated into the same.

On the other hand, catastrophization has shown a negative relationship with pain acceptance. It has been proposed that avoidance, schizoid, dependent and passive personality traits are related to negative way with acceptance, while antisocial, narcissistic and compulsive features are correlated positively with the acceptance and negative to catastrophism.

Among the options to address catastrophization is mindfulness, which contemplates attention at all times and the observation of external and internal stimuli in a non -judicious and non -reactive way, which is contrary to catastrophing, so this alternative could modify the pain.

Finally, an open mind is also recommended to acceptance, new objectives in life, in which it is not trying to control pain, to have a better adaptation and better quality of life in patients with painful conditions.

The pain and management of emotions

Bibliography

• Edwards, r., Giles, j., Bingham, c., Campbell, c., Haythornwaite, j. & Bathon, J. (2010). Moderators of the negative effects of catastrophizing in arthritis. Pain Medicine, 11, 591-599.
• Edwards, r., Mensing, g., CAHALAN, c., Greenbaum, s., Orange, s., Belfer, i., Schreiber, k., Campbell, c., Wasan, a. & Jamison, R. (2012). ALTERATION IN PAIN MODULATION IN WOMEN WITH PERSISTENT PAIN AFTER LUMPECTOMY: Influence of catastrophizing. Journal of Pain Symptom Management, 1-13.