Pain Catastrophizing Is Associated with a Pattern of Negative Emotional States and a Lack of Positive Emotional Priming

Abstract Pain catastrophizing (PC) is a predictor of pain outcomes that is typified by a host of negative changes in mood and cognition, and there is a need to continue defining PC's role in pain and daily life. This study sought to add to the body of literature on PC by investigating the influence of subconsciously presented cues on the interpretation of otherwise ambiguous stimuli. I assessed 216 participants for PC and completed questionnaires that quantified their emotional state and level of behavioral inhibition before and after being exposed to masked primers for either pain/negative emotion, neutral emotion, or happiness. Participants were then asked to interpret ambiguous stimuli (word stems). It was found that the presentation of unpleasant, pain-related masked images resulted in the generation of more negative words than pleasant, non-pain-related masked images. However, the pleasant images failed to result in lower levels of negative words for catastrophizers, indicating a bias to perceive negativity even in pleasant situations. PC was further found to be associated with more negative affect, greater behavioral inhibition, and higher levels of anxiety, pain, and depression. Catastrophizers reported significant negative emotional valence on several indices and did not benefit from masked priming for positive emotions compared to those with less PC. These findings may be useful in defining the parameters of future studies on PC and could be used by clinicians and physicians attempting to treat patients with chronic pain.