• Journal of Oral Medicine and Pain
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• v.40 no.2
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• pp.47-54
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• 2015

Purpose: Besides depression and anxiety, recently pain catastrophizing has been emphasized for an important psychological factor explaining pain response in various pain conditions including temporomandibular disorders (TMDs). The aims of this study were to evaluate pain catastrophizing of TMD patients and to investigate how the level of pain catastrophizing related with clinical variables and psychometric morbidity. Methods: Inclusion criterion was all new TMD patients ${\geq}18$ years old attending the Department of Orofacial Pain and Oral Medicine of Dankook University Dental Hospital (Cheonan, Korea) over three-month period in 2014, who completed questionnaires. The questionnaires included the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Symptom Check List- 90-Revised (SCL-90-R). All of them were examined clinically and diagnosed. Results: One hundred fifty five patients diagnosed as TMDs were participated in this study (mean age of $38.7{\pm}15.2$ years, male:female=1:2.5). Mean PCS score of the patients was 17.3 with standard deviation of 12.6. By the median of the PCS score (i.e., 15), the subjects were categorized into the high (${\geq}15$) and low catastrophizers (<15). Increased pain severity and interference and increased score of psychological features of SCL-90-R were found in the TMD patients with higher level of catastrophizing (p<0.001) and there was weak to moderate correlation between those factors (p<0.05). Difference in catastrophizing level was not found for other variables such as age, gender, duration of pain, education level and types of TMDs. Conclusions: Conclusively, pain catastrophizing of TMD patients relates positively to pain severity and pain interference. In addition to depression and anxiety, pain catastrophizing is positively correlated with variable other psychological morbidity such as somatization, obsessive- compulsive, interpersonal sensitivity, paranoid ideation and psychoticism. Types of TMD diagnosis do not seem to affect catastrophizing level. The results of this study suggest that pain catastrophizing should be emphasized and assessed in the TMD patients.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.177-184
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• 2023

Objective: Manual therapy is a commonly utilized approach in managing chronic pain, but its specific impact on pain catastrophizing remains uncertain. The objective of this systematic review and meta-analysis was to examine the effects of manual therapy on pain catastrophizing in individuals with chronic pain. Design: A systematic review and meta-analysis Methods: A comprehensive search was conducted in electronic databases to identify relevant studies published from 2014 onwards. Studies that evaluated the impact of manual therapy on pain catastrophizing in individuals with chronic pain were incorporated. The risk of bias in the selected studies was evaluated using the Cochrane tool for risk of bias in qualitative analysis. For the quantitative analysis, RevMan 5.4 software was utilized, employing a random-effects model as the analysis model. The effect measure used in the analysis was the standardized mean difference (SMD). Results: In total, 26 studies were collected, and following the screening process, three of them were incorporated into the final analysis. The included studies involved a total of 153 patients with chronic pain. The interventions comprised various manual therapy techniques targeting different areas of the body. Pain catastrophizing and pain intensity were the primary outcomes of interest. The meta-analysis revealed a significant reduction in pain catastrophizing scores following manual therapy intervention compared to control conditions (SMD = -0.91, 95% CI: -1.25 to -0.58). However, heterogeneity between the studies was observed. Conclusions: Despite the limited quantity and heterogeneity of studies, it has been demonstrated that manual therapy intervention is effective in reducing pain catastrophizing in individuals with chronic pain.

• The Korean Journal of Pain
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• v.32 no.1
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• pp.22-29
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• 2019

Background: The aim of this study was to investigate the relationship between pain catastrophizing, acceptance, and quality of life in relation to chronic low back pain in Jakarta, the capital city of Indonesia. We also analyze the effect of personality in catastrophizing and acceptance. Methods: A total of 52 chronic low back pain patients were enrolled as participants from 2 hospitals in Jakarta (43 females, 9 males, mean age 54.38 years). Participants completed a set of self-reported questionnaires: the NEO Five Factor Inventory (NEO-FFI), Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), Pain Catastrophizing Scale (PCS), and Pain Discomfort Module (PDM). Results: This study showed that acceptance increased the patient's quality of life by giving physical relief from pain. In contrast, pain catastrophizing decreased the quality of life, and increased the patients' tendency to get frustrated, irritated, and anxious about the pain. From a personality perspective, the trait neuroticism may lead to a higher level of pain catastrophizing. Conclusions: This study showed that catastrophizing, compared with acceptance, had a greater impact on the patient's life by reducing its quality.

• The Korean Journal of Pain
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• v.31 no.1
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• pp.16-26
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• 2018

Background: The aim of this study was to investigate the association between neuroticism, pain catastrophizing, and experimentally induced pain threshold and pain tolerance in a healthy adult sample from two regions of the country of Croatia: the island of Korcula and city of Split. Methods: A total of 1,322 participants were enrolled from the Island of Korcula (n = 824) and the city of Split (n = 498). Participants completed a self-reported personality measure Eysenck Personality Questionnaire (EPQ) and pain catastrophizing questionnaire Pain Catastrophizing Scale (PCS), followed by a mechanical pain pressure threshold and tolerance test. We have explored the mediating role of catastrophizing in the relationship between neuroticism and pain intensity. Results: The results showed that pain catastrophizing partially mediated the relationship between neuroticism and pain intensity, suggesting the importance of pain catastrophizing in increasing vulnerability to pain. The results also indicated gender-related differences, marked by the higher pain threshold and tolerance in men. Conclusions: This study adds to the understanding of the complex interplay between personality and pain, by providing a better understanding of such mechanisms in healthy adults.

• Journal of Dental Anesthesia and Pain Medicine
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• v.19 no.6
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• pp.379-388
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• 2019

Background: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar. Methods: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use. Results: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05). Conclusion: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.1
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• pp.214-222
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• 2013

This study investigated the relationships between sensory processing patterns and pain catastrophizing levels in well older adults to provide basic information for rehabilitation intervention. The participants of this study were 216 older adults aged over 65. The Adolescent/Adults Sensory Profile(AASP) was used to measure sensory processing patterns and the Pain Catastrophizing Scale(PCS) was employed to evaluate psychological variables of the pain. Self perception of the pain was measured with the Numerical Rating Scale(NRS). Gender and age differences were analyzed with t-test and relationships among sensory processing patterns, pain catastrophizing and pain symptom levels were analyzed with Pearson product-moment coefficients of correlation. Women had higher 'sensory sensitivity' and 'sensory avoiding.' The group over 75 years old had higher 'sensory avoiding,' 'low registration' and 'sensory seeking.' Women had higher pain catastrophizing and pain symptom levels. Negative correlations between 'rumination' and 'low registration' and 'helplessness' and 'sensory seeking' were found. Positive correlations were found between pain catastrophizing and pain symptom levels when they were 'sensory sensitivity' and 'sensory avoiding.' The results infer that sensory processing patterns are associated with psychological variables of the pain and there are differences based on gender and age. Further studies are warranted to support the results.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.87-95
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• 2023

Purpose: To quantify the relationship between perceived pain intensity and psychological variables in a sample of participants with temporomandibular disorder, with or without central sensitization (CS). Methods: A cross-sectional study with nonprobability convenience sampling was conducted from January 1, 2022, to June 30, 2023. Pain intensity (Numeric Pain Rating Scale), anxiety (State-Trait Anxiety Questionnaire, STAI), catastrophizing (Pain Catastrophizing Scale, PCS), perceived stress (Perceived Stress Scale, PSS), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were assessed. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Co.), which included descriptive and normality analyses and the calculation of strength of multiple correlational regression. Results: A total of 52 (n=34 female 65.4%; n=18 male 34.6%) subjects with diagnosis of temporomandibular disorders (TMD) were finally included. A total of 26 participants (n=26, 50.0%) were cases suffered from CS (TMD-CS mean=46.62±11.24) while the remaining participants (n=26, 50.0%) were the controls (TMD-nCS mean=26.77, standard deviation [SD]=8.42). The pain intensity was moderate in both groups TMDCS (mean=7.62, SD=0.83) and TMD-nCS (mean=7.05, SD=0.86), anxiety (TMD-CS STAI mean=53.27, SD=11.54; TMD-nCS STAI mean=49, SD=11.55), catastrophizing (TMD-CS PCS mean=46.27, SD=9.75; TMD-nCS PCS mean=26.69, SD=4.97), perceived stress (TMDCS PSS mean=30.35, SD=4.91; TMD-nCS PSS mean=26.12, SD=6.60) and sleep quality (TMD-CS PSQI mean=15.81, SD=3.65; TMD-nCS PSQI mean=12.77, SD=2.76) levels were measured in both groups. In TMD-CS and TMD-nCS, higher anxiety levels were moderately and significantly associated with greater pain intensity β=0.4467 (t=2.477, p=0.021) and β=0.5087 (t=2.672, p=0.014). Nevertheless, catastrophizing, perceived stress and sleep quality were not associated to pain intensity in neither of group. Conclusions: In both TMD-CS and TMD-nCS patients, elevated anxiety levels were moderately and significantly associated with increased pain intensity. However, heightened levels of pain catastrophizing, perceived stress, and poor sleep quality were not significantly associated with increased pain intensity in either of the two analyzed groups.

• Journal of Oral Medicine and Pain
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• v.45 no.3
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• pp.56-64
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• 2020

Purpose: Temporomandibular disorders (TMD) is a mosaic of clinical signs and symptoms that can be regarded as a set of phenotypes that are affected by various factors including pain sensitivity, pain disability, sleep and psychological functioning. The aims of this study were to evaluate association of pain experience, sleep quality and psychological distress with different phenotypes of TMD patients. Methods: This retrospective study included a cohort (n=1,858; 63.8% for female, mean age=34.9±15.9 years) of patients with TMD. A set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), pain disability (Graded Chronic Pain Scale), sleep quality (Pittsburg Sleep Questionnaire Index), psychological distress (Symptom Checklist-90 revised), and pain catastrophizing (Pain Catastrophizing Scale) were administered to all participants at the first consultation. All TMD patients were classified into four groups including TMD with internal derangement without pain (TMD_ID, n=370), TMD with joint pain (TMD_J, n=571), TMD with muscle pain (TMD_M, n=541) and TMD with muscle-joint combined pain (TMD_MJ, n=376). Results: The female ratio was particularly high in the group with TMD_MJ (p=0.001). The patients with muscle pain and both muscle and joint pain had longer symptom duration (p=0.004) and presented significantly higher scores in pain experience (p<0.001), subjective sleep quality (p<0.001), pain catastrophizing (p<0.001) and psychological distress (p<0.05) except for paranoid-ideation than the groups with only joint problems. Conclusions: The results of this study highlight the importance of multi-dimensional approach that consider pain disability, sleep quality, and psychological functioning in the management of TMD with muscle component. This study would contribute to a better understanding of interaction between heterogeneous TMD and multiple risk factors in order to build tailored treatment based on different phenotypes.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.92-102
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• 2019

Purpose: To investigate the masticatory function of patients with different temporomandibular disorders (TMD) phenotypes, and to explore the risk factors for the masticatory function of TMD patients among multiple biopsychosocial variables using patient-reported outcomes (PROs). Methods: Clinical features and TMD diagnoses of 250 cases were investigated by reviewing medical records. Psychosocial factors were evaluated using four questionnaires representing pain severity and pain interference (Brief Pain Inventory), pain catastrophizing (Pain Catastrophizing Scale, PCS), psychological distress (Symptom Check List-90-Revised, SCL-90R) and kinesiophobia (Tampa Scale for Kinesiophobia for Temporomandibular Disorders, TSK-TMD). Masticatory function, as a dependent variable, was determined using the Jaw Functional Limitation Scale (JFLS). Kruskal-Wallis test and Spearman's rank correlation were used for analyses. Results: A total of 145 cases were included and classified into four subgroups including group 1: TMD with internal derangement without pain (n=14), group 2: TMD with muscle pain (n=32), group 3: TMD with joint pain (n=60) and group 4: TMD with muscle-joint combined pain (n=39). Pain severity (p=0.001) and interference (p=0.022) were the highest in group 2, but the mean global score of JFLS was the highest in group 3, followed by group 4, group 2, and group 1 (p=0.013). Pain severity, pain interference, the mean global score of PCS and the mean global score of TSK-TMD showed significant and moderate correlation with the mean global score of JFLS. All subdimensions and the global severity index of SCL-90R had significant, but weak correlations with all scores of JFLS. Conclusions: The results suggest that masticatory functional limitation depends on the TMD phenotypes. Among the various PROs, pain perception, pain catastrophizing and kinesiophobia seem to be more influential risk factors on jaw function than psychological distress, such as depression and anxiety.

• Anxiety and mood
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• v.12 no.1
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• pp.34-41
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• 2016

Objective : Emotional state and emotion regulation strategies are considered to be important factors influencing the pattern and severity of somatic pain. The aim of this study is to investigate the relationship between cognitive emotional regulation strategies and somatic pain in patients with depression and/or anxiety disorders. Methods : A total of 140 outpatients, diagnosed with depression and/or anxiety disorders according to DSM-IV-TR, were evaluated using the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Numerical Rating Scale (NRS) for somatic pain. Pearson correlations and independent t-tests were performed to analyze the relationship between somatic pain, the severity of depression and/or anxiety and cognitive emotion regulation strategies. Results : The severity of pain was significantly correlated with depressive symptoms, but not with anxiety. Patients with somatic pain tend to use maladaptive cognitive emotion regulating strategies more frequently, especially rumination and catastrophizing. Conclusion : These findings suggest that somatic pain correlates with maladaptive cognitive emotional regulating strategies. Interventions which modulate these non-productive strategies, especially rumination and catastrophizing, would be a new approach for managing patients with depressive and/or anxiety disorders who are suffering from somatic pain.