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Simic K, Savic B, Knezevic NN. Pain Catastrophizing: How Far Have We Come. Neurol Int 2024; 16:483-501. [PMID: 38804476 PMCID: PMC11130925 DOI: 10.3390/neurolint16030036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
The perception of pain is strongly influenced by various social, emotional, and cognitive factors. A psychological variable which has consistently been shown to exert its influence on pain is a cognitive process referred to as pain catastrophizing. Numerous studies have found it to be a strong predictor of pain intensity and disability across different clinical populations. It signifies a maladaptive response to pain marked by an exaggerated negative assessment, magnification of symptoms related to pain, and, in general, a tendency to experience marked pain-related worry, as well as experiencing feelings of helplessness when it comes to dealing with pain. Pain catastrophizing has been correlated to many adverse pain-related outcomes, including poor treatment response, unsatisfactory quality of life, and high disability related to both acute and chronic pain. Furthermore, there has been consistent evidence in support of a correlation between pain catastrophizing and mental health disorders, such as anxiety and depression. In this review, we aim to provide a comprehensive overview of the current state of knowledge regarding pain catastrophizing, with special emphasis on its clinical significance, and emerging treatment modalities which target it.
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Affiliation(s)
- Katarina Simic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
| | - Boris Savic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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Jessa J, Tomfohr-Madsen L, Dhillon A, Walker A, Noel M, Sedov I, Miller JV. Trajectories of pain intensity, pain catastrophizing, and pain interference in the perinatal and postpartum period. Pain Rep 2024; 9:e1137. [PMID: 38333637 PMCID: PMC10852363 DOI: 10.1097/pr9.0000000000001137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/22/2023] [Accepted: 12/12/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Chronic pain (pain >3 months) is a growing epidemic. Normal pregnancy may give rise to recurrent and sometimes constant pain for women. Women with worse pain symptoms are more likely to report symptoms of anxiety, depression, and/or insomnia during the perinatal period, which may impact labor and delivery outcomes. We examined the relationship between demographic and psychological predictors of pain throughout pregnancy and into the postpartum. Objectives To examine trajectories of pain intensity, pain catastrophizing, and pain interference during pregnancy and the early postpartum, and associated sociodemographic predictors of trajectory membership. Methods One hundred forty-two pregnant women were assessed at 4 time points for measures of pain intensity, pain catastrophizing, pain interference, and symptoms of insomnia, depression, and generalized anxiety. Women completed the first survey before 20 weeks' gestation and were reassessed every 10 weeks. Surveys were completed on average at 15 weeks', 25 weeks', and 35 weeks' gestation, and at 6-week postpartum. Using latent class mixed models, trajectory analysis was used to determine trajectories of pain intensity, pain catastrophizing, and pain interference. Results A 1-class pain intensity model, 2-class pain catastrophizing model, and 3-class pain interference model were identified. Adaptive lasso and imputation demonstrated model robustness. Individual associations with trajectories included baseline symptoms of anxiety, depression, and insomnia, and pain symptomology. Conclusion These findings may help to identify women who are at high risk for experiencing pain symptoms during pregnancy and could aid in developing targeted management strategies to prevent mothers from developing chronic pain during their pregnancy and into the postpartum period.
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Affiliation(s)
- Jenna Jessa
- Department of Anesthesiology, Perioperative & Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, AB, Canada
- Child Brain & Mental Health Program, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Lianne Tomfohr-Madsen
- Faculty of Education: Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Ashley Dhillon
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Andrew Walker
- Department of Anesthesiology, Perioperative & Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Alberta Health Services, Calgary, AB, Canada
| | - Melanie Noel
- Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, AB, Canada
- Child Brain & Mental Health Program, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Psychology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ivan Sedov
- Alberta Health Services, Calgary, AB, Canada
| | - Jillian Vinall Miller
- Department of Anesthesiology, Perioperative & Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, AB, Canada
- Child Brain & Mental Health Program, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
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Buin L, Joaquim RHVT, Strong J, Robinson K. The Experience of Pregnancy-Related Lumbopelvic Pain: A Qualitative Evidence Synthesis. Can J Occup Ther 2024; 91:29-43. [PMID: 37170547 DOI: 10.1177/00084174231172037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background. Pregnancy-related lumbopelvic pain is common and can impact quality of life. Purpose. To synthesize existing qualitative research on people's experiences of pregnancy-related lumbopelvic pain in pregnancy and during the postpartum period. Method. A keyword search of four electronic databases between 2000 and 2022 was completed. Included studies were appraised and synthesized using a meta-ethnographic approach. Findings. Twenty-three studies were included. Analysis identified four core themes: (1) uncertainties about pregnancy-related lumbopelvic pain, (2) struggles to attain achieve treatment and pain management, (3) profound activity consequences, and (4) emotional wellbeing, relationship, and identity impacts of pregnancy-related lumbopelvic pain. Implications. The occupational therapy role with this population has not to our knowledge yet been described. Given the centrality of occupational disruption to the experience of this population we argue that developing and evaluating occupational therapy interventions to address functional, work, parenting and wellbeing outcomes for this population is warranted and should be prioritized.
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Okyay EK, Uçar T. The effect of emotional freedom technique and music applied to pregnant women who experienced prenatal loss on psychological growth, well-being, and cortisol level: A randomized controlled trial. Arch Psychiatr Nurs 2023; 45:101-112. [PMID: 37544684 DOI: 10.1016/j.apnu.2023.04.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/10/2023] [Accepted: 04/30/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Research has shown that application of emotional freedom technique and music ensures psychological growth, increases well-being, and decreases cortisol level. PURPOSE In the study, it was aimed to determine the effect of EFT and music applied to pregnant women who had experienced prenatal loss on their psychological growth, well-being, and cortisol level. METHODS The study was conducted as a randomized controlled trial in a city hospital in eastern Türkiye with 159 pregnant women, 53 of whom were in the EFT, 53 in the music group, and 53 in the control group. The study data were collected through Subjective Units of Disturbance Scale (SUDS), Subjective Units of Experience (SUE) Scale, Post Traumatic Growth Inventory (PTGI), and WHO-5 Well-Being Index, and saliva samples were taken for cortisol evaluation. EFT was applied to the women two times every other week; the women in the music group listened to music two times every other week. Throughout the week following the first intervention, the women continued the interventions at home. RESULTS It was determined that EFT and music significantly decreased the participants' subjective anxiety and salivary cortisol median scores, the lowest anxiety was in the EFT group, and PTGI and WHO-5 Well-Being Index mean scores increased (p < 0.005). Further analyses showed that EFT was more effective in terms of increasing well-being than music (p < 0.001; a > b > c). It was determined that the anxiety levels and salivary cortisol median values of the control group were statistically significantly higher compared to the EFT and music groups (p < 0.001). CONCLUSION It was found that EFT and music applied to the women who had experienced prenatal loss decreased anxiety, ensured psychological growth, improved well-being, and decreased salivary cortisol level.
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Affiliation(s)
- Esra Karataş Okyay
- Kahramanmaras Sutcu Imam University, Department of Midwifery, 46050 Kahramanmaras, Türkiye.
| | - Tuba Uçar
- Inonu University, Department of Midwifery, 44280 Malatya, Türkiye.
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Maternal pain during pregnancy dose-dependently predicts postpartum depression: The Japan Environment and Children's Study. J Affect Disord 2022; 303:346-352. [PMID: 35038477 DOI: 10.1016/j.jad.2022.01.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Postpartum depression (PPD) affects women during the first year after delivery. This study investigated the association between prenatal pain (maternal pain during pregnancy) and PPD. METHODS Data were analyzed from the Japan Environment and Children's Study (JECS), a nationwide prospective birth cohort study. Information on prenatal pain was collected twice during pregnancy through self-administered questionnaires. PPD symptoms were assessed using the Edinburgh Postnatal Depression Scale at one month postpartum. Poisson regression analyses were performed to investigate the association between prenatal pain and PPD, with other putative risk factors adjusted in the model. RESULTS Among 84,801 study subjects, 11,535 (13.6%) were screened as positive for PPD. In the present study, the occurrence of prenatal pain was 69.6 and 84.0% at the first trimester and the second/third trimester, respectively. A positive relationship between any degree of pain and PPD in both the first and the second/third trimester was observed. A significant linear dose-dependent association was also found (Ptrend < 0.001) when the subjects were divided by the severity of pain. Using participants without any pain at either point as a reference, those with persistent pain both at the first and the second/third trimesters showed the highest risk for PPD: aRR = 1.95 (95%CI: 1.76-2.15; p < 0.001). LIMITATIONS No detailed information regarding the type or site of prenatal pain was available in the JECS questionnaires, neither did data concerning delivery and postpartum pain. CONCLUSIONS The study results suggest that prenatal pain is a dose-dependent risk factor for the development of PPD.
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Catala P, Suso-Ribera C, Marin D, Bedmar D, Peñacoba C. A longitudinal study exploring the evolution of pain during pregnancy and after delivery: does worry matter? Arch Womens Ment Health 2021; 24:759-766. [PMID: 33837828 DOI: 10.1007/s00737-021-01127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
The aim of this study is to evaluate the evolution of pain through pregnancy until after delivery, as well as to explore the mediating role of pregnancy worries in this evolution of pain. We conducted a longitudinal cohort study. The convenience sample was evaluated on four separate occasions: in the first trimester of pregnancy (pain), during the third trimester (pain and worry), during labor (pain), and after birth (< 24 h; pain). The final sample included 120 pregnant women with a mean age of 31.29 years (SD = 4.9; range = [22, 42 years]). The results evidenced changes in pain over time (F = 13.31, p < .001). Pain severity increased in the third trimester compared to the first trimester (t = - 4.60; 95% CI = [- 1.31, - 0.52]; p < .001), while pain during the third trimester and pain after delivery were comparable (t = - 0.94; 95% CI = [- 1.02, 0.36]; p = .35). Pain during labor was uncorrelated with all other pain measures, so it was not included in the model. The results of the mediation analyses indicated a total effect of pain during pregnancy (first and third trimester) and worry on pain severity after delivery (B = 0.35; SE = 0.14; t = 2.43; 95% CI = [0.06, 0.65]; p = .017). Pregnancy worries (B = 0.14; SE = 0.07; 95% CI = [0.06, 0.29]), but not pain during the third trimester (B = 0.03; SE = 0.12; 95% CI = [- 0.17, 0.31]) mediated the relationship between pain during the first trimester and pain after delivery. These results support the need to reduce worry in pregnant mothers, especially when pain during the first trimester is high, to reduce the risk of pain after delivery.
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Affiliation(s)
- Patricia Catala
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcón, Madrid, Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Castellón, Spain
| | - Dolores Marin
- Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,Obstetrics Department, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Dolores Bedmar
- Pain Unit, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Cecilia Peñacoba
- Department of Psychology, Rey Juan Carlos University, Avda. de Atenas s/n, 28922, Alcorcón, Madrid, Spain.
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Aldabe D, Lawrenson P, Sullivan J, Hyland G, Bussey M, Hammer N, Bryant K, Woodley S. Management of women with pregnancy-related pelvic girdle pain: an international Delphi study. Physiotherapy 2021; 115:66-84. [DOI: 10.1016/j.physio.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022]
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Tan HS, Agarthesh T, Tan CW, Sultana R, Chen HY, Chua TE, Sng BL. Perceived stress during labor and its association with depressive symptomatology, anxiety, and pain catastrophizing. Sci Rep 2021; 11:17005. [PMID: 34417541 PMCID: PMC8379208 DOI: 10.1038/s41598-021-96620-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/13/2021] [Indexed: 12/24/2022] Open
Abstract
Perceived stress is a dimension of the maternal stress response, however little data is available on perceived stress levels and its associated psychological risk factors during labor. In this secondary data analysis from a prospective study evaluating epidural regimens, we investigated the potential associations between depressive symptomatology, anxiety, and pain catastrophizing with perceived stress during labor. Healthy nulliparous adult women with term singleton pregnancies requesting for epidural analgesia in early labor were included. Assessments were administered after epidural analgesia and adequate pain relief were achieved. Perceived stress (Perceived Stress Scale, PSS, high PSS ≥ 16), depressive symptomatology (Edinburgh Postnatal Depression Scale, EPDS, high EPDS ≥ 10), and pain catastrophizing (Pain Catastrophizing Scale, PCS, high total PCS ≥ 25) were assessed as categorical variables. Additionally, anxiety (State-trait Anxiety Inventory, STAI), PCS total and its subscales (rumination, magnification and helplessness) were analyzed as continuous variables. Univariate and multivariable logistic regression models were used to identify factors associated with high PSS. Of 801 women included, 411 (51.9%) had high PSS. High EPDS (OR 2.16, 95%CI 1.36–3.44), increasing trait anxiety (OR 1.17, 95%CI 1.14–1.20), and increasing pain magnification (OR 1.12, 95%CI 1.05–1.19) were independently associated with high PSS. Depressive symptomatology, trait anxiety, and pain magnification were associated with perceived stress during labor, providing impetus for future research aimed at detecting and alleviating stress and its psychological or pain association factors.
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Affiliation(s)
- Hon Sen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore
| | - T Agarthesh
- Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Chin Wen Tan
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore.,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
| | - Rehena Sultana
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Helen Yu Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Tze-Ern Chua
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore, Singapore.,Pediatrics Academic Clinical Program, Duke-NUS Medical School, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Ban Leong Sng
- Department of Women's Anesthesia, KK Women's and Children's Hospital, Singapore, Singapore. .,Anesthesiology and Perioperative Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
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