The role of catastrophism and disease representation in adapting to chronic pain

Background: Chronic pain is a widespread condition that is often associated with psychological distress, disability, and worse quality of life. Previous research shows that both catastrophic thinking and illness representation predict poorer chronic pain adjustment. This study investigates the interplay between catastrophising and illness representation to explain adaptation to chronic pain. Methods: A total of 30 patients with chronic pain participated in the study. Patients completed measures of catastrophism (PCS), illness representations (IPQ-R), depression (BDI), anxiety (STAI-Y), disability (PDI), quality of life (Q-LES-SR), and pain (VAS). Regression analyses were used to explore the contribution of catastrophising and illness representation to explain outcome measures. Results: The results showed the catastrophism and some dimensions of the IPQ-R correlate positively with outcome variables. The IPQ-R-Identity dimension predicted disability and depression, while negative emotional representations predicted a worse quality of life. When the Identity dimension was entered into the regression models, the contribution of catastrophising to predict depression and disability was not statistically significant, suggesting several mediational pathways. Indeed, secondary analyses suggested that the Identity dimension mediates the relationship between the PCS-Impotence dimension and disability, on one hand, and between the Impotence and depression, on the other hand. Conclusion: These results extend the empirical evidence on the importance of the two constructs in the adaptation to chronic pain and the need to further investigate their role.