Pain catastrophizing is associated with enhanced pain and pain-related outcomes. Unfortunately, the mechanisms underlying the catastrophizing-pain relationship are poorly understood. Given evidence suggesting significant relationships among catastrophizing, emotion, and pain, it is possible that catastrophizing may alter nociception and pain through affective processes. Research has shown that emotionally charged pictures (erotica, neutral, threat/attack scenes) manipulate emotional valence (positive affect vs negative affect) and modulate physiological and subjective nociceptive reactions (pleasure-induced inhibition, displeasure-induced facilitation). Using this methodology, the present study addressed 2 questions: (1) Does pain catastrophizing moderate affective reactions to standard emotional stimuli (eg, augmented negative affect)? and (2) Does pain catastrophizing moderate the relationship between emotion and nociception (eg, augmented displeasure-induced facilitation)? Erotic, neutral, and attack pictures were presented to 53 participants who rated their emotional responses. During pictures, noxious electric stimulations were delivered to evoke nociceptive reactions (nociceptive flexion reflex, skin conductance response, heart rate acceleration, subjective pain). Results suggest that pain catastrophizing did not moderate emotional reactions to standardized picture stimuli, nor did catastrophizing moderate the influence of emotion on nociceptive reactions. This suggests that catastrophizing does not influence pain indirectly through emotional processes.
Perspective: Pain catastrophizing is commonly associated with negative emotions and maladaptive responses to pain. The current study provides evidence indicating catastrophizing does not alter pain and nociception indirectly via emotional processes.