Geoff P Bostick1, Cory Toth, Bruce D Dick, Eloise C J Carr, Larry W Stitt, Dwight E Moulin. 1. Departments of *Physical Therapy ‡Anaesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada †Department of Clinical Neurosciences §Faculties of Nursing and Graduate Studies, University of Calgary, Calgary, AB, Canada ∥LW Stitt Statistical Services, London, ON, Canada ¶Departments of Clinical Neurological Sciences and Oncology and Earl Russell Chair of Pain Medicine, Western University, London, ON, Canada.
Abstract
OBJECTIVES: To study the relationship between expected pain and future outcomes along with the moderating effects of expected pain in neuropathic pain patients. METHODS: Study participants were recruited for the Canadian Neuropathic Pain Database. To examine the relationship between expected pain and 6-month pain intensity, pain-related disability, and catastrophizing, multiple regressions were performed. These relationships were adjusted for potential confounding (age, sex, baseline pain intensity, and psychological distress). To evaluate the moderating effect of expected pain on the relationship between baseline pain intensity and 6-month outcomes, pain intensity×expected pain interaction terms were created. RESULTS: Complete data for analysis was available for 560 patients (71%). Expected pain was positively correlated with pain intensity and pain-related disability scores at 6 months. The relationship between baseline pain intensity and 6-month catastrophizing scores was moderated by expected pain (however, despite a similar trend, expected pain did not statistically moderate the relationship between baseline pain intensity and 6-month pain intensity or disability). At higher levels of pain, predicted catastrophizing scores were higher for those with low levels of expected pain than those with high levels of expected pain. An opposite relationship was observed for patients with the lower levels of pain. DISCUSSION: In neuropathic pain patients whose pain does not respond to therapy, high levels of expected pain may relate to relatively lower catastrophizing scores by shifting focus away from futile attempts at "curing" pain toward focusing on achievement of more realistic personal goals.
OBJECTIVES: To study the relationship between expected pain and future outcomes along with the moderating effects of expected pain in neuropathic painpatients. METHODS: Study participants were recruited for the Canadian Neuropathic Pain Database. To examine the relationship between expected pain and 6-month pain intensity, pain-related disability, and catastrophizing, multiple regressions were performed. These relationships were adjusted for potential confounding (age, sex, baseline pain intensity, and psychological distress). To evaluate the moderating effect of expected pain on the relationship between baseline pain intensity and 6-month outcomes, pain intensity×expected pain interaction terms were created. RESULTS: Complete data for analysis was available for 560 patients (71%). Expected pain was positively correlated with pain intensity and pain-related disability scores at 6 months. The relationship between baseline pain intensity and 6-month catastrophizing scores was moderated by expected pain (however, despite a similar trend, expected pain did not statistically moderate the relationship between baseline pain intensity and 6-month pain intensity or disability). At higher levels of pain, predicted catastrophizing scores were higher for those with low levels of expected pain than those with high levels of expected pain. An opposite relationship was observed for patients with the lower levels of pain. DISCUSSION: In neuropathic painpatients whose pain does not respond to therapy, high levels of expected pain may relate to relatively lower catastrophizing scores by shifting focus away from futile attempts at "curing" pain toward focusing on achievement of more realistic personal goals.
Authors: Gianluca Castelnuovo; Emanuele M Giusti; Gian Mauro Manzoni; Donatella Saviola; Arianna Gatti; Samantha Gabrielli; Marco Lacerenza; Giada Pietrabissa; Roberto Cattivelli; Chiara A M Spatola; Stefania Corti; Margherita Novelli; Valentina Villa; Andrea Cottini; Carlo Lai; Francesco Pagnini; Lorys Castelli; Mario Tavola; Riccardo Torta; Marco Arreghini; Loredana Zanini; Amelia Brunani; Paolo Capodaglio; Guido E D'Aniello; Federica Scarpina; Andrea Brioschi; Lorenzo Priano; Alessandro Mauro; Giuseppe Riva; Claudia Repetto; Camillo Regalia; Enrico Molinari; Paolo Notaro; Stefano Paolucci; Giorgio Sandrini; Susan G Simpson; Brenda Wiederhold; Stefano Tamburin Journal: Front Psychol Date: 2016-04-19