Theoretical perspectives on the relation between catastrophizing and pain

The tendency to "catastrophize" during painful stimulation contributes to m ore intense pain experience and increased emotional distress. Catastrophizi ng has been broadly conceived as an exaggerated negative "mental set" broug ht to bear during painful experiences. Although findings have been consiste nt in showing a relation between catastrophizing and pain, research in this area has proceeded in the relative absence of a guiding theoretical framew ork. This article reviews the literature on the relation between catastroph izing and pain and examines the relative strengths and limitations of diffe rent theoretical models that could be advanced to account for the pattern o f available findings. The article evaluates the explanatory power of a sche ma activation model, an appraisal model, an attention model, and a communal coping model of pain perception. It is suggested that catastrophizing migh t best be viewed from the perspective of hierarchical levels of analysis, w here social factors and social goals may play a role in the development and maintenance of catastrophizing, whereas appraisal-related processes may po int to the mechanisms that link catastrophizing to pain experience. Directi ons for future research are suggested.