Individuals who experience pain often engage in catastrophizing (CAT), a cognitive style involving rumination about pain, magnification of perceived threat, and a feeling of helplessness to cope with the pain. Moreover, high levels of catastrophizing have been shown to lead to poorer pain outcomes, such as lower pain tolerance and greater pain-related disability. Training in cognitive coping skills can help individuals to manage pain more effectively. In the current study, 111 pain-free undergraduate participants completed two modalities of experimental pain tasks (pressure, cold pressor) before and after an intervention targeted at reducing CAT through three cognitive-behavioral coping strategies: distraction, mindfulness/acceptance of pain, and cognitive restructuring. Pain responses from this group were compared to two other groups, one that underwent a positive mood induction procedure and one that underwent a similar procedure aimed at having no effect on mood (neutral mood group), which served as a control group. Participants also completed a new measure, the Catastrophizing Visual Analog Scale (CAT-VAS), designed to assess in-the-moment CAT during pain tasks. This new measure improves upon previous retrospective self-report measures of CAT given that CAT measured during or immediately after the pain experience accounts for more variance in pain responses (e.g., Edwards, Campbell, & Fillingim, 2005). Overall, the cognitive skills group showed lower CAT, higher pain tolerance, and greater reductions in subjective pain report post-intervention than either the positive or neutral mood groups. In addition, the CAT-VAS was more powerful in predicting pain response than existing retrospective questionnaire measurements. The results provide support for cognitive appraisal and fear-avoidance models of pain and pain coping, in which rumination and negative appraisal of pain escalate over time and promote a continued state of pain and distress whereas active coping attempts lead to greater pain relief.
|Advisor:||Gil, Karen M.|
|Commitee:||Abramowitz, Jonathan S., Bauer, Daniel J., Gil, Karen M., Hollins, Mark, Neblett, Enrique W.|
|School:||The University of North Carolina at Chapel Hill|
|School Location:||United States -- North Carolina|
|Source:||DAI-B 73/01, Dissertation Abstracts International|
|Subjects:||Clinical psychology, Experimental psychology|
|Keywords:||Assessment, Cold pressor, Coping, Experimental pain, Pain catastrophizing|
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