Pain Catastrophizing and its Domains Significantly Impact Rheumatoid Arthritis Disease Activity, 2025, Currado et al

V

voner

Senior Member (Voting Rights)

Abstract​

This study aims to evaluate the impact of pain catastrophizing (PC) on disease activity in patients with rheumatoid arthritis (RA) and to explore, in the same participants, if this association is related or not with anxiety and depression, which have been related to catastrophization in patients with chronic pain. A multi-center, observational study has been conducted on 158 RA patients from six Rheumatology Clinics. Participants were assessed using the Clinical Disease Activity Index (CDAI) and Simple Disease Activity Index (SDAI) and Disease Activity Score on 28 joints- C reactive protein (DAS28-CRP). Pain Catastrophizing, with its domains of Helplessness, Rumination and Magnification, was analyzed through Pain Catastrophizing Scale (PCS). Statistical analyses included univariable and multivariable regressions, to identify associations between disease activity and PC. Results revealed that higher PCS scores were significantly associated with increased CDAI, SDAI and DAS28-CRP values, indicating higher disease activity. Specifically, the domains of Rumination and Helplessness showed a strong correlation with disease activity, while Magnification did not. These associations persisted independently of anxiety and depression mood, as shown by multivariable regression analysis. Pain catastrophizing, particularly the domains of Rumination and Helplessness, significantly influences disease activity in RA patients, independent of mood disorders. These findings underscore the importance of addressing maladaptive cognitive perceptions of pain in the management of RA, to improve patient outcomes and facilitate disease remission.

open access: https://www.nature.com/articles/s41598-025-21749-1.pdf
 
voner said:
Pain catastrophizing, particularly the domains of Rumination and Helplessness, significantly influences disease activity in RA patients, independent of mood disorders.
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The good old trick of inferring one-way causality from correlation.
voner said:
These findings underscore the importance of addressing maladaptive cognitive perceptions of pain in the management of RA, to improve patient outcomes and facilitate disease remission.
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Good luck treating RA with CBT..
 
Utsikt said:
The good old trick of inferring one-way causality from correlation.
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And measuring something non specific, and calling it a specific causal hypothesis (catastrophising).

For example, here is the scale they used to measure catastrophising (Pain Catasrophising Scale). It seems to me someone with awful pain could tick all of those and not be catastrophising. I doubt it’s a very good scale.
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A small point. I never met a person with RA who emphasised their pain. Most were quite reticent about it. It had become a normal part of their life by the time they got to me. Most of the time they underplayed it, hoping that I would say things were not too bad or they didn't have chronic arthritis. Lupus patients often emphasised pain more because they had already met professionals who thought nothing much was wrong because there was nothing to see.

The lack of psychological insight of psychologists never ceases to amaze me.
 
Jonathan Edwards said:
God help us.
Pain is going to 'impact' disease activity scores because they include an assessment of pain.
If any newer members are interested in examples of just how bad most biomedical research seems to be these days (which the old lags need no reminding of) try this one.
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Seems to me to be pretty standard biopsychosocial, where they include bits of biology but screw it all up by misinterpreting associations out of bad questionnaires.

And yeah this is just embarrassing. Silly, even. They keep taking associations that run in an obvious direction, but argue that it must work the other way around. It just has to, because the most plausible explanation has been declared forbidden, or something like it.

It's actually far more embarrassing than most of the criticisms laid on LLMs, because humans are more than capable of working through the steps for why this is obviously wrong, and every LLM out there would even agree with the correction if they somehow got it wrong and started making post facto rationalizations.
 
Yann04 said:
And measuring something non specific, and calling it a specific causal hypothesis (catastrophising).

For example, here is the scale they used to measure catastrophising (Pain Catasrophising Scale). It seems to me someone with awful pain could tick all of those and not be catastrophising. I doubt it’s a very good scale.
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Those questions are so weird that it seems fit to question the sanity of a system that treats them seriously. Even propagandists would recoil at how they are comically biased to the point of being cringe.
 
Utsikt said:
The good old trick of inferring one-way causality from correlation.
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Yann04 said:
And measuring something non specific, and calling it a specific causal hypothesis (catastrophising).
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The term is so loaded with arbitrary causal attribution that it has become a major source of bias in and of itself.

Unfortunately this is not an isolated example in psych. If anything the entire field is heavily contaminated by this problem.

Jonathan Edwards said:
The lack of psychological insight of psychologists never ceases to amaze me.
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It is genuinely astounding that the one psychological understanding they seem to be most resistant to acknowledging, or even simply lack completely, is into the psychology of the experimenter themselves, and why it is so fundamentally important to control for it.

I agree with @rvallee. We are way past the point where it can be ascribed to mere error or ignorance. It has been going on for so long, against all explicit evidence and warnings, including from within the profession itself, that it now cannot be interpreted as anything but conscious intent.

That's the problem.
 
"Maladaptive conceptions of pain"

Good grief penfold.

Talk about gaslighting in the extreme. I bet if they ever experienced that much pain themselves their "conceptions" about it would soon change to be "maladaptive" too.

How about respecting the lived experience for once. :banghead:
 
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