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The relationship between negative metacognitive thoughts, pain catastrophizing and adjustment to chronic pain
Author(s) -
Ziadni M.S.,
Sturgeon J.A.,
Darnall B.D.
Publication year - 2018
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1160
Subject(s) - pain catastrophizing , worry , psychology , metacognition , anxiety , clinical psychology , coping (psychology) , chronic pain , mood , moderation , cognition , distress , psychiatry , social psychology
Abstract Background Cognitive appraisals, most notably pain catastrophizing, play an important role in chronic pain. The role of metacognition and its impact on the relationship between pain catastrophizing and health are understudied. The identification of metacognition as a moderator of psychological constructs may have clinical and empirical implications. We hypothesized that negative metacognitive beliefs would moderate the relationships between pain catastrophizing and emotional functioning and physical activity. Method Participants ( N = 211) with mixed aetiology chronic pain were primarily Caucasian females with severe average pain intensity. Over the course of 2 weeks, participants completed online daily‐diary measures of pain catastrophizing, pain intensity, mood, physical activity and metacognition. Results Participants with higher average levels of daily pain intensity and negative metacognitive beliefs about worry reported higher levels of daily pain catastrophizing, as well as daily depression, and anxiety. Some aspects of metacognitive beliefs (i.e. dangerousness and uncontrollability of thoughts) were also negatively associated with average daily levels of positive affect. However, these effects were not interactive; metacognitive beliefs did not moderate the relationships of pain catastrophizing with other daily variables. Conclusions From a daily coping perspective, findings reveal that people with stronger negative metacognitive beliefs report greater emotional distress on a day‐to‐day basis. However, negative metacognitive beliefs did not appear to modify the effects of pain catastrophizing on psychological and physical functioning at the daily level, suggesting that metacognitive beliefs may be better conceptualized as a more parallel indicator of emotional maladjustment to chronic pain whose effects do not reliably manifest in daily measurement models. Significance Findings highlight the need to better characterize the value of metacognitive beliefs as an important predictor and therapeutic target. Despite limited evidence of a dynamic relationship between metacognition and daily adjustment to chronic pain, results emphasize the potential importance of interventions that target cognitive appraisal process beyond catastrophizing, including uncontrollability and danger‐laden thought patterns.