Sezai Özkan1,2, Emily L Zale3,4, David Ring5, Ana-Maria Vranceanu6. 1. Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA, 02114, USA. 2. Department of Trauma Surgery, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. 3. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Street, Boston, MA, 02114, USA. 4. Department of Psychology, Syracuse University, 430 Huntington Hall, Syracuse, NY, 13244, USA. 5. Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, 1400 Barbara Jordan Blvd. Suite 2.834, MC: R1800, Austin, TX, 78723, USA. 6. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, 1 Bowdoin Street, Boston, MA, 02114, USA. avranceanu@mgh.harvard.edu.
Abstract
BACKGROUND: Patients who present to hand surgery practices are at increased risk of psychological distress, pain, and disability. Greater catastrophic thinking about pain is associated with greater pain intensity, and initial evidence suggest that, together, catastrophic thinking about pain and cognitive fusion (i.e., interpretation of thoughts as true) are associated with poorer pain outcomes. PURPOSE: We tested whether cognitive fusion or catastrophic thinking interacts in relation to pain and upper extremity physical function among patients seeking care from a hand surgeon. METHODS: Patients (N = 110; mean age= 47.51; 59% women) presenting to an outpatient hand surgery practice completed computerized measures of sociodemographics, pain intensity, cognitive fusion, catastrophic thinking about pain, and upper extremity function. RESULTS: ANCOVA revealed an interaction between cognitive fusion and catastrophic thinking about pain with respect to pain intensity and upper extremity function (ps < .01). Participants who scored high on both cognitive fusion and catastrophic thinking about pain reported the greatest levels of pain, relative to those who scored high on a single measure. The lowest levels of upper extremity function were also observed among those who scored high on both catastrophic thinking about pain and cognitive fusion. A similar pattern of results was observed when we tested each catastrophizing subscale individually. CONCLUSION: Maladaptive cognitions about pain (i.e., catastrophic thinking) may be particularly problematic when interpreted as representative of reality (i.e., cognitive fusion). Psychosocial interventions addressing catastrophic thinking about pain and cognitive fusion concurrently merit investigation among people with hand and upper extremity illness.
BACKGROUND:Patients who present to hand surgery practices are at increased risk of psychological distress, pain, and disability. Greater catastrophic thinking about pain is associated with greater pain intensity, and initial evidence suggest that, together, catastrophic thinking about pain and cognitive fusion (i.e., interpretation of thoughts as true) are associated with poorer pain outcomes. PURPOSE: We tested whether cognitive fusion or catastrophic thinking interacts in relation to pain and upper extremity physical function among patients seeking care from a hand surgeon. METHODS:Patients (N = 110; mean age= 47.51; 59% women) presenting to an outpatient hand surgery practice completed computerized measures of sociodemographics, pain intensity, cognitive fusion, catastrophic thinking about pain, and upper extremity function. RESULTS: ANCOVA revealed an interaction between cognitive fusion and catastrophic thinking about pain with respect to pain intensity and upper extremity function (ps < .01). Participants who scored high on both cognitive fusion and catastrophic thinking about pain reported the greatest levels of pain, relative to those who scored high on a single measure. The lowest levels of upper extremity function were also observed among those who scored high on both catastrophic thinking about pain and cognitive fusion. A similar pattern of results was observed when we tested each catastrophizing subscale individually. CONCLUSION: Maladaptive cognitions about pain (i.e., catastrophic thinking) may be particularly problematic when interpreted as representative of reality (i.e., cognitive fusion). Psychosocial interventions addressing catastrophic thinking about pain and cognitive fusion concurrently merit investigation among people with hand and upper extremity illness.
Entities:
Keywords:
Catastrophic thinking; Cognitive fusion; Upper extremity function
Authors: Deepanjli Donthula; Joost T P Kortlever; David Ring; Erin Donovan; Lee M Reichel; Gregg A Vagner Journal: Clin Orthop Relat Res Date: 2020-02 Impact factor: 4.755
Authors: Amanda I Gonzalez; Joost T P Kortlever; Laura E Brown; David Ring; Mark Queralt Journal: Clin Orthop Relat Res Date: 2021-06-01 Impact factor: 4.755