Fear of pain, pain catastrophizing, and acute pain perception: relative prediction and timing of assessment

J Pain. 2008 Sep;9(9):806-12. doi: 10.1016/j.jpain.2008.03.012. Epub 2008 May 16.


Pain-related fear and catastrophizing are important variables of consideration in an individual's pain experience. Methodological limitations of previous studies limit strong conclusions regarding these relationships. In this follow-up study, we examined the relationships between fear of pain, pain catastrophizing, and experimental pain perception. One hundred healthy volunteers completed the Fear of Pain Questionnaire (FPQ-III), Pain Catastrophizing Scale (PCS), and Coping Strategies Questionnaire-Catastrophizing scale (CSQ-CAT) before undergoing the cold pressor test (CPT). The CSQ-CAT and PCS were completed again after the CPT, with participants instructed to complete these measures based on their experience during the procedure. Measures of pain threshold, tolerance, and intensity were collected and served as dependent variables in separate regression models. Sex, pain catastrophizing, and pain-related fear were included as predictor variables. Results of regression analyses indicated that after controlling for sex, pain-related fear was a consistently stronger predictor of pain in comparison to catastrophizing. These results were consistent when separate measures (CSQ-CAT vs PCS) and time points (pretask vs "in vivo") of catastrophizing were used. These findings largely corroborate those from our previous study and are suggestive of the absolute and relative importance of pain-related fear in the experimental pain experience.

Perspective: Although pain-related fear has received less attention in the experimental literature than pain catastrophizing, results of the current study are consistent with clinical reports highlighting this variable as an important aspect of the experience of pain.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adaptation, Psychological / physiology
  • Adult
  • Anxiety / psychology
  • Cold Temperature / adverse effects
  • Fear / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pain / complications
  • Pain / physiopathology*
  • Pain / psychology*
  • Pain Measurement / methods*
  • Pain Threshold
  • Perception / physiology
  • Predictive Value of Tests
  • Regression Analysis
  • Sex Factors
  • Stress, Psychological / etiology
  • Stress, Psychological / psychology
  • Surveys and Questionnaires
  • Time Factors