Exploring the interplay between catastrophizing and endometriosis pain through 2-wave and intensive longitudinal data

De França Moreira, Marcelo, Marcelo França Moreira, Marco Aurelio Pinho Oliveira, Marco Aurélio Pinho Oliveira
Pain medicine (Malden, Mass.) · 2024 · vol. 26(4) , pp. 207–215 · doi:10.1093/pm/pnae132 · PMID:39731739 · W4405862607
article OA: closed CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

High pain catastrophizing significantly worsens endometriosis pain trajectories over four weeks, with bidirectional influences mediated distinctly by sensory and affective pain dimensions.

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Abstract

BACKGROUND: Endometriosis, characterized by the presence of endometrial-like tissue outside the uterus, results in chronic pelvic pain. However, lesion characteristics alone cannot fully explain the complexity of endometriosis-related pain. Pain catastrophizing, a cognitive process that influences pain perception, has traditionally been studied through cross-sectional or 2-wave designs, which struggle to capture its dynamic interplay with endometriosis pain. To address these gaps, our study explores the bidirectional relationship between pain catastrophizing and pain outcomes-including intensity, frequency, and flares-over a detailed 4-week period and an aggregated 30-day time frame and across sensory and affective dimensions. METHODS: A latent growth curve model assessed the relationship between pain catastrophizing, initial pain levels, and endometriosis pain trajectories over 4 weeks. Additionally, 4 mediator models explored how baseline pain catastrophizing affects various pain aspects, including sensory and affective dimensions, and its subsequent influence on pain catastrophizing. RESULTS: Results indicate that high levels of pain catastrophizing significantly escalate endometriosis pain over 4 weeks, affecting average pain intensity, episode frequency, and flares over 30 days. Pain catastrophizing also adversely impacts sensory and affective dimensions. These elements partially mediate baseline pain catastrophizing's effect on week 5 levels, revealing a bidirectional relationship. Notably, whereas the affective dimension amplifies subsequent pain catastrophizing, the sensory dimension exerts a contrasting negative association. CONCLUSION: The study highlights the bidirectional influence between pain catastrophizing and several aspects of endometriosis-related pain. Sensory and affective dimensions play distinct roles, with implications for personalized interventions. Limitations and clinical relevance are discussed. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials ID: U1111-1233-4802.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Catastrophization Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (46)

Cited by (2)

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