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Pain in childbirth and postpartum recovery: the role of catastrophizing
Örebro University, School of Law, Psychology and Social Work. (Center for Health and Medical Psychology (CHAMP))ORCID iD: 0000-0003-2718-7402
Örebro University, School of Law, Psychology and Social Work. (Center for Health and Medical Psychology)
Örebro University, School of Law, Psychology and Social Work. (Center for health and Medical Psychology)ORCID iD: 0000-0001-5359-0452
2009 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 13, no 3, 312-316 p.Article in journal (Refereed) Published
Abstract [en]

This prospective study investigated how pain catastrophizing was related to labor pain intensity and physical recovery after childbirth. Eighty-eight women giving birth for the first time completed the first questionnaire before delivery. Eighty-two of those returned the second questionnaire after delivery. Participants were classified as catastrophizers (n=38) or non-catastrophizers (n=44) based on their scores on the Pain Catastrophizing Scale. Comparison of the groups showed that catastrophizers anticipated and experienced more intense pain (p<.0125) and had poorer physical recovery (p<.0125), measured as the level of self-reported functioning in activities of daily living, than non-catastrophizers. These results extend the association between catastrophizing and pain, to pain and recovery in childbirth and provide support for the fear-avoidance model. It is concluded that pain catastrophizing plays a role in the experience of pain in childbirth and postpartum recovery. Further research is needed to identify appropriate interventions for catastrophizing women during the latter part of pregnancy.

Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2009. Vol. 13, no 3, 312-316 p.
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-5886DOI: 10.1016/j.ejpain.2008.04.010ISI: 000264243300013PubMedID: 18515162OAI: oai:DiVA.org:oru-5886DiVA: diva2:200953
Available from: 2009-03-02 Created: 2009-03-02 Last updated: 2017-03-24Bibliographically approved
In thesis
1. Stuck in mind: the role of catastrophizing in pain
Open this publication in new window or tab >>Stuck in mind: the role of catastrophizing in pain
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2011. 71 p.
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 21
Keyword
catastrophizing, pain, fear avoidance, problem solving
National Category
Social Sciences Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-19125 (URN)978-91-7668-826-7 (ISBN)
Public defence
2011-12-02, Hörsal L2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:15
Opponent
Supervisors
Available from: 2011-10-04 Created: 2011-10-04 Last updated: 2016-12-05Bibliographically approved

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