Anxiety Sensitivity and Pain Catastrophizing: Distinct Factors in Predicting Pain

1. Anxiety Sensitivity and Pain Catastrophizing: Distinct Factors in Predicting Pain Susan T. Heinze, Jamie L. Elftman, W. Hobart Davies University of Wisconsin-Milwaukee PURPOSE/BACKGROUND RESULTS RESULTS (CONTINUED) • Further analyses were run to determine the relationship of both AS and PC to pain-related variables. All ASI and PCS scores were significantly related to HRQOL. • Pain frequency, intensity, and duration were significantly correlated with total PCS and all 3 subscales. The ASI was less predictive of the pain variables. See Table 2. • Both anxiety sensitivity (AS) and pain catastrophizing (PC) have been noted as predisposing factors for chronic pain. • These constructs may increase fear and avoidance of pain, which perpetuates pain sensitivity and decreased health-related quality of life (HRQOL; Stewart & Asmundson, 2006). • While there is a wealth of research relating each of these factors to chronic pain, there are few studies which include both AS and PC. • It is the goal of this study to demonstrate that although these two constructs are related, they are distinct entities. • Hypotheses: PC will predict pain intensity, frequency and duration, while AS will be a broader risk factor and will be less predictive of these pain variables compared to PC. • The PCS and ASI total scores were significantly correlated (r = .48, p < .001). All 6 of the subscales across both measures were also found to be significantly and positively correlated with each other, with between measure subscale correlation coefficients ranging from r = .25 to .47, all p < .001. • The ASI total score was more strongly correlated with all 3 ASI subscales (r = .81, .82, .86, all p < .001) than all 3 PCS subscales (r = .36, .46, .46, p < .001). • The PCS total score was more strongly correlated with all 3 PCS subscales (r = .89, .86, .91, p < .001) than all 3 ASI subscales (r = .37, .45, .38, p < .001). • In order to assess whether the ASI and PCS are measuring two separate constructs, a factor analysis including all 18 ASI items and all 13 PCS items was conducted. • Although the two measures were correlated on every subscale, the results of the factor analysis demonstrated that ASI and PCS items loaded onto different factors. The 31 items loaded onto six factors, four consisting of ASI items, and 2 with PCS items; there was no overlap of items between measures. See Table 1. Table 2. Correlations between PC and AS and pain-related variables Table 1. Factor analysis of ASI and PCS METHODS * p< .05; **p< .01 • This data was collected as part of a larger online community sample survey. Data were collected as part of an undergraduate psychology course in which students recruited young adults from the community • Participant characteristics: • N = 470; 55% female • Young adults between 18 and 24 years old • (M age = 21.63, SD = 1.71 ) • Caucasian (81%); full-time college students (60%) • Measures: • Demographic information • Pain information on pain frequency, severity and duration, • SF12: 12-item measure of health-related quality of life • Anxiety Sensitivity Index (ASI): 18-item measure of AS • Total score and three subscales: Physical, Cognitive, and Social • Pain Catastrophizing Scale (PCS): 13-item measure of PC • Total score and three subscales: Rumination, Magnification, and Helplessness CONCLUSION • The results suggest that both AS and PC are important to consider in the experience of pain. The correlations between the two measures constructs suggest that AS and PC share common variance regarding negative evaluations of physical sensations. • The items of the two measures loaded separately in a factor analysis, and have different predictive values. The ASI and the PCS may measure different constructs that assess catastrophizing over different somatic events (Drahovzal, Stewart & Sullivan, 2006). • The ASI measures fears of somatic experiences, while the PCS is specific to experiences of pain. This is supported by the finding that PCS scores were more significantly correlated with pain severity, frequency, and duration. • Further research is required regarding the distinct roles of PC and AS. Based on this study, it appears that PC is more closely related to chronic pain than AS, however both may be worthy targets of treatment. For more information, please contact Susan Heinze, stheinze@uwm.edu Presented at the 2010 APA Annual Convention