Journal of Kerman University of Medical Sciences

An Investigation of the Mediating Role of Catastrophizing in the Relationship of High Neuroticism and Extraversion with Fear of Movement and Pain Intensity in Chronic Musculoskeletal Pain Sufferers

Document Type : Original Article

Authors

Maryam Amini-Fasakhoodi 1
Majid Mahmood Alilou 2
Abbas Bakhshipour-Roudsari 2

1 Department of Psychology, School of Education and Psychology, University of Tabriz, Tabriz, Iran

2 Professor, Department of Psychology, School of Education and Psychology, University of Tabriz, Tabriz, Iran

Abstract
Background & Aims: The current study aimed to investigate the role of catastrophizing as mediator variable in the relationship of neuroticism and extraversion with fear of movement and pain intensity in patients with musculoskeletal pain.
Methods: This study was conducted on 200 subjects who were selected through purposive sampling from among the clients of Shohada, Emam Hossein, and Sina Hospitals in Tehran, Iran, and the Pain Clinic in Tabriz, Iran. The subjects completed the Five-Factor Inventory (NEO-FFI), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), and Visual analog scale (VAS). The data were analyzed using LISREL software through path analysis method.
Results: Among the personality traits, neuroticism had a positive impact on catastrophizing, and thus, caused fear of movement and pain intensity in patients with chronic pain. However, extraversion and openness to experience with a negative impact on catastrophizing caused a reduction in fear of movement and pain intensity.
Conclusion: Based on the results of this study, neuroticism, through decreasing the pain threshold, causes catastrophizing and results in higher degrees of fear of movement and pain intensity. Nevertheless, extraversion (through increasing the pain threshold, and thus, decreases sensitivity to physical and sensory stimuli) and openness to experiences (due to high flexibility in the face of new experiences) have negative effects on catastrophizing.

Keywords

Chronic pain
Pain intensity
Catastrophizing
Fear of movement
neuroticism
extraversion
openness to experience
  1. Melzack R, Wall PD. Pain mechanisms: a new theory. Survey of Anesthesiology 1967; 11(2): 89-90.
  2. Renn CL, Dorsey SG. The physiology and processing of pain: a review. AACN Clin Issues 2005; 16(3): 277-90.
  3. Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. 2nd ed. Washington, DC: IASP Press; 1994.
  4. Gatchel RJ, Turk DC. Psychosocial factors in pain: critical perspectives. New York, NY: Guilford Press; 1999.
  5. Arnstein P. The mediation of disability by self-efficacy in different samples of chronic pain patients. Disabil Rehabil 1999; 22(17): 794-801.
  6. Geisser ME, Robinson ME, Keefe FJ, Weiner ML. Catastrophizing, depression and the sensory, affective and evaluative aspects of chronic pain. Pain 1994; 59(1): 79-83.
  7. Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment 1995; 7(4): 524-32.
  8. Crombez G, Eccleston C, Baeyens F, Eelen P. When somatic information threatens, catastrophic thinking enhances attentional interference. Pain 1998; 75(2-3): 187-98.
  9. Buer N, Linton SJ. Fear-avoidance beliefs and catastrophizing: occurrence and risk factor in back pain and ADL in the general population. Pain 2002; 99(3): 485-91.
  10. Asghari A, Nicholas MK. Personality and pain-related beliefs/coping strategies: a prospective study. Clin J Pain 2006; 22(1): 10-8.
  11. Esteve R, Ramirez-Maestre C, Lopez-Marinez AE. Adjustment to chronic pain: the role of pain acceptance, coping strategies, and pain-related cognitions. Ann Behav Med 2007; 33(2): 179-88.
  12. Ramirez-Maestre C, Esteve R, López AE. Neuroticismo, afrontamiento y dolor crónico. Anales De Psicologí 2001; 17(1): 129-37.
  13. Ramirez-Maestre C, Lopez Martinez AE, Zarazaga RE. Personality characteristics as differential variables of the pain experience. J Behav Med 2004; 27(2): 147-65.
  14. Ramirez-Maestre C, Esteve R, Lopez AE. Cognitive appraisal and coping in chronic pain patients. Eur J Pain 2008; 12(6): 749-56.
  15. Ramirez-Maestre C, Esteve R, Lopez AE. The path to capacity: resilience and spinal chronic pain. Spine (Phila Pa 1976) 2012; 37(4): E251-E258.
  16. Ramirez-Maestre C, Esteve R, Lopez AE. The role of optimism and pessimism in chronic pain patients adjustment. Span J Psychol 2012; 15(1): 286-94.
  17. Asghari MA, Nicholas MK. Personality and adjustment to chronic pain. Pain Rev 1999; 6(1): 85-97.
  18. Goubert L, Crombez G, Van DS. The role of neuroticism, pain catastrophizing and pain-related fear in vigilance to pain: a structural equations approach. Pain 2004; 107(3): 234-41.
  19. Watson D, Pennebaker JW. Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychol Rev 1989; 96(2): 234-54.
  20. Geisser ME, Roth RS, Theisen ME, Robinson ME, Riley JL, III. Negative affect, self-report of depressive symptoms, and clinical depression: relation to the experience of chronic pain. Clin J Pain 2000; 16(2): 110-20.
  21. Eysenck HJ. Biological basis of personality. Nature 1963; 199: 1031-4.
  22. Martinez MP, Sanchez AI, Miro E, Medina A, Lami MJ. The relationship between the fear-avoidance model of pain and personality traits in fibromyalgia patients. J Clin Psychol Med Settings 2011; 18(4): 380-91.
  23. Affleck G, Tennen H, Urrows S, Higgins P. Neuroticism and the pain-mood relation in rheumatoid arthritis: insights from a prospective daily study. J Consult Clin Psychol 1992; 60(1): 119-26.
  24. Lightsey OR, Wells AG, Wang MC, Pietruszka T, Çiftçi A, Stancil B. Emotion-oriented coping, avoidance coping, and fear of pain as mediators of the relationship between positive affect, negative affect, and pain-related distress among African American and Caucasian college women. The Counseling Psychologist 2009; 37(1): 116-46.
  25. Ramirez-Maestre C, Esteve R. Disposition and adjustment to chronic pain. Curr Pain Headache Rep 2013; 17(3): 312.
  26. Eysenck HJ. The biological basis of personality. New Jersey, NJ: Transaction Publishers; 1967.
  27. Stelmack RM. Biological bases of extraversion: psychophysiological evidence. J Pers 1990; 58(1): 293-311.
  28. Ziesat HA, Gentry WD. The pain apperception test: an investigation of concurrent validity. J Clin Psychol 1978; 34(3): 786-9.
  29. Lynn R, Eysenck HJ. Tolerance for pain, extra version and neuroticism. Perceptual and Motor Skills 1961; 12: 161-2.
  30. Harkins SW, Price DD, Braith J. Effects of extraversion and neuroticism on experimental pain, clinical pain, and illness behavior. Pain 1989; 36(2): 209-18.
  31. Dubayova T, Nagyova I, Havlikova E, Rosenberger J, Gdovinova Z, Middel B, et al. Neuroticism and extraversion in association with quality of life in patients with Parkinson's disease. Qual Life Res 2009; 18(1): 33-42.
  32. Bolger N. Coping as a personality process: a prospective study. J Pers Soc Psychol 1990; 59(3): 525-37.
  33. Costa PT, McCrae RR. Personality: another "Hidden Factor" in stress research. Psychological Inquiry 1990; 1(1): 22-4.
  34. Endler NS, Parker JD. Multidimensional assessment of coping: a critical evaluation. J Pers Soc Psychol 1990; 58(5): 844-54.
  35. Epstein S, Meier P. Constructive thinking: a broad coping variable with specific components. J Pers Soc Psychol 1989; 57(2): 332-50.
  36. Gunthert KC, Cohen LH, Armeli S. The role of neuroticism in daily stress and coping. J Pers Soc Psychol 1999; 77(5): 1087-100.
  37. McCrae RR, Costa PT. Personality, coping, and coping effectiveness in an adult sample. Journal of Personality 1986; 54(2): 385-404.
  38. Medvedova L. Personality dimensions-'Little Five'-and their relationships with coping strategies in early adolescence. Studia Psychol 1998; 40: 261-5.
  39. Gomez R, Holmberg K, Bounds J, Fullarton C, Gomez A. Neuroticism and extraversion as predictors of coping styles during early adolescence. Personality and Individual Differences 1999; 27(1): 3-17.
  40. Rim Y. Ways of coping, personality, age, sex and family structural variables. Personality and Individual Differences 1986; 7(1): 113-6.
  41. Sánchez-Cánovas J, Sánchez-López M. Psicología diferencial: diversidad e individualidad humanas. Madrid, Spain: Centro de Estudios Ramon Areces; 1994. [In Spanish].
  42. Mohamadi S, Dehghani M, Heidari M, Sedaghat M, Khatibi A. The evaluation of pain-related psychological similarities among patients with musculoskeletal chronic pain and their spouses. Journal of Behavioral Sciences 2013; 7(1): 17-8. [In Persian].
  43. Kori SH, Miller RP, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Manage 1990; 3: 35-40.
  44. Dehghani M, Sharpe L, Nicholas MK. Selective attention to pain-related information in chronic musculoskeletal pain patients. Pain 2003; 105(1-2): 37-46.
  45. Roelofs J, Peters ML, Fassaert T, Vlaeyen JW. The role of fear of movement and injury in selective attentional processing in patients with chronic low back pain: a dot-probe evaluation. J Pain 2005; 6(5): 294-300.
  46. Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H. Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance. Pain 1995; 62(3): 363-72.
  47. Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain 2005; 117(1-2): 137-44.
  48. Jafari H, Ebrahimi E, Salavati M, Kamali M, Fata L. Tampa Scale for Kinesiophobia: cross-cultural adaptation, factor structure, and psychometric properties in Iranian low back pain patients. J Rehab 2010; 11(1): 15-22. [In Persian].
  49. Khatibi A, Dehghani M, Sharpe L, Asmundson GJ, Pouretemad H. Selective attention towards painful faces among chronic pain patients: evidence from a modified version of the dot-probe. Pain 2009; 142(1-2): 42-7.
  50. Costa PT, McCrae RR. Revised NEO personality inventory (NEO PI-R) and NEO five-factor inventory (NEO-FFI). Florida, FL: Psychological Assessment Resources, 1992.
  51. Garosi T. New approaches to personality assessment: Application of factor analysis in personality studies. Tabriz, Iran: Jamepazhooh Publication; 2001. [In Persian].
  52. Jöreskog K, Sörbom D. LISREL 8: user's reference guide. Chicago, IL: Scientific Software International, 2005.
  53. Soriano J, Monsalve V, Gómez-Carretero P, Ibáñez E. Vulnerable personality profile in patients with chronic pain: Relationship with coping, quality of life and adaptation to disease. International Journal of Psychological Research 2012; 5(1): 42-51.
  54. Schmidt JE, Hooten WM, Carlson CR. Utility of the NEO-FFI in multi-dimensional assessment of orofacial pain conditions. J Behav Med 2011; 34(3): 170-81.
  55. Jerram KL, Coleman PG. The big five personality traits and reporting of health problems and health behaviour in old age. British Journal of Health Psychology 1999; 4(2): 181-92.
  56. Phillips, M, Gatchel R. Extraversion-introversion and chronic pain. In: Gatchel RJ, Weisberg JN, Editors. Personality characteristics of patients with pain. 1st ed. Washington, DC: Amer Psychological Assn; 2000.
  57. Connor-Smith JK, Flachsbart C. Relations between personality and coping: a meta-analysis. J Pers Soc Psychol 2007; 93(6): 1080-107.
  58. Rainville J, Carlson N, Polatin P, Gatchel RJ, Indahl A. Exploration of physicians' recommendations for activities in chronic low back pain. Spine (Phila Pa 1976) 2000; 25(17): 2210-20.
  59. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 2001; 17(1): 52-64.
Journal of Kerman University of Medical Sciences
Volume 23, Issue 1
2016
Pages 55-67

Home

Editorial Board

Guide for Authors

Submit Manuscript

Guide for Reviewers

Contact Us