The Temporal Relationship between Catastrophizing and Chronic Pain

Introduction/Aim: Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic pelvic pain syndrome characterized by persistent pain localized to the bladder and urologic symptoms of urgency, frequency, and dysuria (Nickel et al., 2009). While the temporal relationship between catastrophizing and chronic pain has been examined in other chronic pain populations (e.g., Campbell et al., 2012), the present study is the first to investigate this temporal relationship in an IC/BPS sample. Methods: 151 women diagnosed with IC/BPS were recruited from tertiary care urology clinics and completed the Short Form McGill Pain Questionnaire and the Pain Catastrophizing Scale at baseline (Time 1), 6 months post-baseline (Time 2), and 12-months post-baseline (Time 3). Two cross-lagged panel analysis were conducted using residualized change scores. Results: Increases in catastrophizing between Time 1 and Time 2 (Early Catastrophizing Change) predicted increases in pain between Time 2 and Time 3 (Later Pain Change), after controlling for early changes in pain and later changes in catastrophizing. In contrast, increases in pain between Time 1 and Time 2 (Early Pain Change) did not predict increases in catastrophizing between Time 2 and Time 3 (Later Catastrophizing Change), after controlling for early changes in catastrophizing and later changes in pain. Discussion/Conclusions: Early increases in catastrophizing predict later increases in pain levels among patients with IC/BPS, but not vice versa. These findings add to the growing body of research emphasizing the importance of catastrophizing in the development and maintenance of chronic pain. Clinical implications include targeting catastrophizing for the management of IC/BPS pain.