(524) The impact of catastrophizing and fear of pain and (re)injury on pain intensity, perceived disability, and recovery expectancies among individuals with spinal cord injury

Abstract

Pain catastrophizing and kinesiophobia (fear of pain and re/injury due to movement) are consistently associated with negative psychosocial and functional outcomes in a variety of musculoskeletal conditions. While many individuals with spinal cord injury (SCI) report significant pain experience, research on these pain-related constructs remains limited in this population. The current study examined associations between fear of pain and (re)injury (Tampa Scale of Kinesiophobia), pain catastrophizing (Pain Catastrophizing Scale) and pain outcomes, perceived disability, and recovery expectancies among individuals (n = 36) undergoing inpatient rehabilitation following SCI. Bivariate analyses indicated that pain catastrophizing, but not fear of pain, was significantly associated with greater current pain intensity (0-10 NRS, Present Pain Intensity Index of the Short Form McGill Pain Questionnaire; MPQ-SF-PPI; r = .51 and .40, respectively). Both pain catastrophizing and fear of pain were significantly associated with greater level of perceived disability (Perceived Disability Questionnaire; r = .44 and .55, respectively). Hierarchical regression analyses indicated that pain catastrophizing uniquely accounted for variance in current pain intensity (NRS; MPQ-SF-PPI) above and beyond demographic variables and injury-related variables, including level of SCI and time since injury (R2change = .17 and .29, respectively). Regression analyses controlling for demographic and injury-related variables as well as current pain intensity indicated that participants’ fear of pain but not pain catastrophizing significantly accounted for variance in perceived disability (R2change = .15). Finally, analysis of recovery expectancies revealed that pain catastrophizing was associated with less positive expectancies regarding resumption of work responsibilities (r = -.40). Fear of pain was likewise strongly associated with reduced expectancies in the domain of sexual function (r = -.56). The current study offers preliminary understanding of the influence of pain catastrophizing and kinesiophobia on perceived disability immediately post-injury and expectations for recovery after an acquired SCI.