Rumination, Magnification, and Helplessness: How do Different Aspects of Pain Catastrophizing Relate to Pain Severity and Functioning?

Objectives: Although there is a large body of research on the relationship between pain catastrophizing and functioning among individuals with chronic pain, little is known about the potential differential impact of specific aspects of pain catastrophizing. The current study evaluates the relationship between the Rumination, Helplessness, and Magnification subscales of the Pain Catastrophizing Scale and pain-related outcomes.

Materials And Methods: In total, 844 patients who were admitted to a chronic pain rehabilitation program completed survey measures of pain, catastrophizing, quality of life (QOL), and depression.

Results: A series of analyses were conducted entering the 3 subscales simultaneously in a predictive model after pain intensity and demographic variables (ie, age, sex, pain duration, current opioid use). The Helplessness subscale accounted for unique variance in the prediction of pain severity, pain-related interference, mental and physical health-related QOL, and depressed mood. Magnification was significantly related to physical and mental health-related QOL and depressed mood. The Rumination subscale was not uniquely associated with any of the outcome measures beyond that which was accounted for by pain severity, magnification, or helplessness.

Discussion: Pain catastrophizing is a multifaceted construct, and different domains of catastrophizing are uniquely related to pain-related outcomes. This study represents the first to evaluate the functioning of these subscales in a large, diagnostically heterogeneous sample of chronic pain patients.