The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study

Clin J Pain. 2005 Sep-Oct;21(5):439-45. doi: 10.1097/01.ajp.0000135236.12705.2d.


Objectives: This study was a prospective investigation of the extent to which psychologic variables could be predictive of postoperative pain. Study aims were: 1) to evaluate whether an assessment of pre-operative distress factors could predict the intensity of postoperative pain; and 2) to characterize the unique pattern in which anxiety and pain catastrophizing scores relate to postoperative pain.

Methods: The Pain Catastrophizing Scale and the State-Trait Anxiety Inventory were administered to 38 patients scheduled for elective abdominal surgery. The questionnaires were completed on the day of admission, a day before the operation. On day 1 and day 2 following the operation, perception of pain intensity at the surgical wound was assessed by visual analog scale.

Results: The Pain Catastrophizing Scale and State-Trait Anxiety Inventory scores were significantly correlated with the postoperative pain scores. A linear regression analysis showed that Pain Catastrophizing Scale predicted the level of postoperative pain intensity even after controlling for state anxiety and that trait anxiety was not a significant predictor. In addition, analysis of the unique pattern of each predictor related to postoperative pain intensity indicated a linear curve for the Pain Catastrophizing Scale and curvilinear curve for the state anxiety.

Discussion: The results are discussed in light of appraisal and coping theories. It is suggested that a simple assessment of preoperative catastrophizing tendency and anxiety scores may assist medical teams in postoperative pain management.

Publication types

  • Clinical Trial

MeSH terms

  • Anxiety / diagnosis*
  • Anxiety / epidemiology*
  • Causality
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Israel / epidemiology
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / diagnosis*
  • Pain, Postoperative / epidemiology*
  • Personality Inventory
  • Prognosis
  • Prospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Severity of Illness Index
  • Statistics as Topic