The role of catastrophizing and depression in the prediction of affective, behavioral, and cognitive responses to cold pressor pain
The present study investigated the role of catastrophizing and laboratory induced depressed mood in the prediction of responses to cold pressor pain. Participants consisted of 101 (28 men and 73 women) undergraduate psychology students. The study excluded individuals who reported a history of frostbite, medical conditions affecting the left arm, significant depressive symptoms, current use of antidepressant medications, or use of antihistamines, anticholinergic, or analgesic medications during the 24 hours preceding the experiment. Baseline pain threshold and pain tolerance times were determined using the Cold Pressor Test (CPT). Participants were then assigned to depressed, neutral, or elated mood induction conditions in a consecutive manner according to order of arrival for the experiment, and groups were balanced for gender and ethnicity. Mood was induced using the Velten Mood Induction Procedure; (VMIP) and the Multiple Affect Adjective Checklist-Revised was administered as a mood manipulation check. The CPT was then re-administered and pain threshold and pain tolerance times assessed, followed by modified versions of the McGill Pain Questionnaire (MPQ) and the Pain Catastrophizing Scale (PCS). Results indicated that the VMIP was effective at inducing mood states. However, unexpectedly, pain tolerance and pain threshold from the second CPT were unaffected by mood state. Results determined that catastrophizing predicted lower pain tolerance and lower pain threshold, in addition to the scores on the Affective and Evaluative subscales of the MPQ, indicating that individuals who engaged in catastrophizing had greater emotional and cognitive responses to pain. Gender differences in catastrophizing were determined such that women were more likely to catastrophize; however, catastrophizing did not mediate the relationship between gender and responses to pain, while controlling for the effects of depressed mood. Thus, this study provides additional support for previous findings concerning the role of catastrophizing in the experience of pain, while depression played a less significant role. Clinical implications concerning catastrophizing and various cognitions about pain are discussed and recommendations for future research are suggested.