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Understanding catastrophizing from a misdirected problem-solving perspective
Örebro universitet, Akademin för juridik, psykologi och socialt arbete. (Center for Health and Medical Psychology (CHAMP))ORCID-id: 0000-0003-2718-7402
Örebro universitet, Akademin för juridik, psykologi och socialt arbete.ORCID-id: 0000-0001-9429-9012
Örebro universitet, Akademin för juridik, psykologi och socialt arbete.
Örebro universitet, Akademin för juridik, psykologi och socialt arbete.ORCID-id: 0000-0001-5359-0452
2012 (Engelska)Ingår i: British Journal of Health Psychology, ISSN 1359-107X, E-ISSN 2044-8287, Vol. 17, nr 2, s. 408-419Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives.  The aim is to explore pain catastrophizing from a problem-solving perspective. The links between catastrophizing, problem framing, and problem-solving behaviour are examined through two possible models of mediation as inferred by two contemporary and complementary theoretical models, the misdirected problem solving model (Eccleston & Crombez, 2007) and the fear-anxiety-avoidance model (Asmundson, Norton, & Vlaeyen, 2004).

Design.  In this prospective study, a general population sample (n= 173) with perceived problems with spinal pain filled out questionnaires twice; catastrophizing and problem framing were assessed on the first occasion and health care seeking (as a proxy for medically oriented problem solving) was assessed 7 months later.

Methods.  Two different approaches were used to explore whether the data supported any of the proposed models of mediation. First, multiple regressions were used according to traditional recommendations for mediation analyses. Second, a bootstrapping method (n= 1000 bootstrap resamples) was used to explore the significance of the indirect effects in both possible models of mediation.

Results.  The results verified the concepts included in the misdirected problem solving model. However, the direction of the relations was more in line with the fear-anxiety-avoidance model. More specifically, the mediation analyses provided support for viewing catastrophizing as a mediator of the relation between biomedical problem framing and medically oriented problem-solving behaviour.

Conclusion.  These findings provide support for viewing catastrophizing from a problem-solving perspective and imply a need to examine and address problem framing and catastrophizing in back pain patients.

Ort, förlag, år, upplaga, sidor
Wiley-Blackwell, 2012. Vol. 17, nr 2, s. 408-419
Nationell ämneskategori
Psykologi
Forskningsämne
Psykologi
Identifikatorer
URN: urn:nbn:se:oru:diva-19741DOI: 10.1111/j.2044-8287.2011.02044.xISI: 000301175800011PubMedID: 22106932Scopus ID: 2-s2.0-84858025240OAI: oai:DiVA.org:oru-19741DiVA, id: diva2:446270
Tillgänglig från: 2011-10-06 Skapad: 2011-10-06 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
Ingår i avhandling
1. Stuck in mind: the role of catastrophizing in pain
Öppna denna publikation i ny flik eller fönster >>Stuck in mind: the role of catastrophizing in pain
2011 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Pain catastrophizing emerges in the literature as one of the most important psychological determinants of both pain itself and the negative outcomes commonly associated with it. However, despite decades of research confirming the impact of catastrophizing, there are still areas that remain unexplored or in which the surface has only been scratched. The overall aim of this dissertation was to expand existing knowledge about catastrophizing and to advance the theoretical framework around the concept.

The role of catastrophizing was explored in three distinct areas: during pain in childbirth, in exposure treatment for back pain patients, and in a problem solving context. The findings from the three studies confirmed the vital role of catastrophizing in these areas. Firstly, catastrophizing played a critical role in pain in childbirth; women who catastrophized reported labor pain as more intense and the subsequent recovery period as longer than women who did not catastrophize. Secondly, catastrophizing was identified as a moderator of treatment effect in exposure in vivo for back pain patients with pain-related fear; patients who catastrophized were not helped by the exposure. Thirdly, catastrophizing played a role in a problem solving context; although this is in line with contemporary models such as the misdirected problem solving model, the results suggested a somewhat different pathway to this previous model. Taken together, these findings underscore the instrumental role of catastrophizing in diverse areas and imply a need for catastrophzing to be assessed and addressed in clinical contexts. In addition, the findings highlight a need for further development of the theoretical framework around catastrophizing as well as treatment interventions that directly target catastrophizing. Based on these needs, a new model of catastrophizing was proposed – a model of catastrophizing from a process perspective. In this model, the proposed function of catastrophizing is to down-regulate negative affect, as a form of internal avoidance. The model is a complement to existing theoretical models and provides a framework for developing treatment interventions that directly target catastrophizing, for example by problem solving skills training. Successful interventions for people who catastrophize would lead to several gains – for the individual in less suffering and increased ability to handle pain problems, and for society as a whole in reduced costs for health care for these individuals.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro universitet, 2011. s. 71
Serie
Örebro Studies in Psychology, ISSN 1651-1328 ; 21
Nyckelord
catastrophizing, pain, fear avoidance, problem solving
Nationell ämneskategori
Samhällsvetenskap Psykologi
Forskningsämne
Psykologi
Identifikatorer
urn:nbn:se:oru:diva-19125 (URN)978-91-7668-826-7 (ISBN)
Disputation
2011-12-02, Hörsal L2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:15
Opponent
Handledare
Tillgänglig från: 2011-10-04 Skapad: 2011-10-04 Senast uppdaterad: 2017-10-17Bibliografiskt granskad

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