Lower educational attainment has been linked to worse chronic pain outcomes, but the reasons for this relationship are unclear. This study analyzed the relationship between level of education and pain outcomes in patients with musculoskeletal pain, and potential psychosocial mechanisms to explain this relationship. We hypothesized that patients with lower educational attainment would report greater pain intensity and interference, and that pain catastrophizing, anxiety, and depression would mediate the relationship between educational attainment and pain. A total of 843 participants (63% female, 78% White, Mage=55.13), diagnosed with a musculoskeletal pain condition [knee osteoarthritis (29%), back pain (57%), and fibromyalgia (14%)], completed questionnaires including demographics, Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scales (HADS). Pearson correlations and bootstrapped mediation analyses were conducted to examine the relationships among education, psychosocial, and pain variables. Education was inversely correlated with pain intensity and interference, pain catastrophizing, anxiety, and depression (p < .05). Pain catastrophizing significantly mediated the relationship between education and pain intensity (95%CI [-.05, -.01]), and catastrophizing and depression mediated the effects of education on pain interference (95% CI [-.08, -.01]; 95%CI [-.06, -.01]). Anxiety did not mediate either relationship. These findings indicate that greater pain catastrophizing, and in part depression, partly drive the relationship between lower educational attainment and worse pain outcomes. This work importantly aims to reduce pain disparities and provides direction for psychosocial treatment, suggesting that pain catastrophizing may be a particularly critical target in patients with lower education level. / 2026-02-23T00:00:00Z

Pain catastrophizing (PC) and fear of pain (FOP) are understudied across different race/ethnicity minorities. The association between these constructs and psychological disorders with relation to chronic pain are understudied as well. Prior research indicates that racial/ethnic minority populations may engage in more PC and FOP than white, non-Hispanic populations. These studies, however, have only examined macro-level differences between white, non-Hispanic and minority populations. Less is known about the nuanced differences in PC and FOP across individual racial/ethnic groups (i.e., white vs. Asian vs. Black/African American). The current study explores between-group differences in PC and FOP across diverse racial/ethnic groups of youth with chronic pain while also observing the association between anxiety/depression and PC/FOP in these populations. Youth (ages 11-17) with chronic pain presenting for treatment to a tertiary pediatric pain clinic completed the Pain Catastrophizing Scale (PCS), which includes a total score and subscales (i.e., rumination, magnification, and helplessness) and the Fear of Pain Questionnaire. Racial/ethnic group sizes were as follows: Black/non-Hispanic (N = 29), Hispanic (N = 58), Asian (N = 17), another race/non-Hispanic (N = 37), and Multiracial (N = 15). One-way ANOVAs were conducted to test differences in the PCS total score and subscales as well as FOP among racial/ethnic groups, and Chi-square analyses were conducted to test the association between binary codes of anxiety/depression diagnoses provided in the data repository and the race/ethnicity minorities, respectively. Results revealed non-significant differences in total PCS and PCS subscales across race/ethnicity minority groups. In addition, there were no statistically significant differences in FOP across race/ethnicity minority groups. However, there were some clinically significant differences between mean PCS and FOP scores across certain racial/ethnic minority groups. Finally, no significant associations emerged between anxiety and race/ethnicities or between depression and race/ethnicities. Findings suggest that youth with chronic pain may experience PC and FOP similarly regardless of their racial/ethnic backgrounds. However, these findings were limited by small sample sizes across groups, and future research with larger sample sizes is warranted. These results can inform continued exploration and sensitivity to diversity, equity, and inclusivity issues in healthcare for pediatric chronic pain patients.

No description available.

No description available.

La perturbation dans le fonctionnement affectif peut contribuer à des symptômes psychologiques et physiques chez les patients souffrant de fibromyalgie. La question qui nous intéresse dans cette étude est d’explorer certains processus du traitement émotionnel et leurs liens avec des variables cognitives, au sein de la fibromyalgie. Notre population se compose de 24 fibromyalgiques, comparés à 24 patients polyarthrites rhumatoïdes et 27 sujets contrôles. Notre hypothèse est que la perception et la mémorisation des stimuli de nature émotionnelle est affectée par certains processus de traitement émotionnel. Notamment nos résultats mettent en évidence une particularité émotionnelle et mnésique pour un matériel émotionnel standardisé. / The disturbance in emotional operation can contribute to psychological and physical symptoms among patients suffering from fibromyalgia. The question which interests us in this study is to explore certain processes of the emotional treatment and their links with cognitive variables, within the fibromyalgia. Our population is composed of 24 fibromyalgics, compared to 24 polyarthritises rhumatoïdes patients and 27 control subjects. Our assumption is that the perception and the memorizing of the stimuli of emotional nature are affected by certain treatments emotional. In particular our results highlight an emotional and memory characteristic for a standardized emotional material.

Base teórica: A dor crônica decorre de alterações estruturais e funcionais mal adaptativas que influenciam a resposta ao estímulo ou que sustentam os processos de excitabilidade. Um dos sintomas que permeia grande número de pacientes com dor crônica é a catastrofização, cujas características são um conjunto de pensamentos negativos, deseperança e magnificação do sintoma ou condição. Este sintoma é mensurado por meio de uma escala de catastrofização usada em vários países. No entanto não dispomos deste instrumento validado para o português.Objetivos: Validar para o português do Brasil (B) a PCS e verificar suas propriedades psicométricas. Verificar a consistência interna, estrutura fatorial, e sua capacidade de discriminar pacientes com condições específicas de dor crônica como cefaleia tensional crônica (CTC) (International Headache Society) e fibromialgia de acordo com os critérios do American College of Rheumatology. Avaliar os possíveis mecanismos neurobiológicos correlacionados com o nível de sintomas catastróficos, através de dosagens de cortisol e TNF em uma amostra de pacientes com CTC. Métodos: 384 sujeitos com idades entre 18-79 anos com dor crônica de origem músculo-esquelética participaram deste estudo transversal. A versão da B-PCS foi aplicada, assim como a intensidade da dor, interferência da dor na capacidade funcional, no humor e um questionário sócio-demográfico. A capacidade discriminatória da B-PCS foi avaliada numa sub-amostra de pacientes com cefaléia tensional crônica (CTC) de acordo com os critérios da International Headache Society (n = 19), e em outro com diagnóstico de fibromialgia segundo os critérios do American College of Rheumatology (n = 50). Após a validação a B-PCS foi aplicada num grupo de pacientes com CTC. Foi avaliado o impacto da cefaleia usando o Short-Form Headache Impact Test (HIT-6), coletadas amostras de cortisol salivar às 08:00; 16:00 e 22:00 e dosado o TNF sérico. Resultados: Observou-se boa consistência interna [valores α de Cronbach de 0,91 para o total da BR-PCS. Para os subdomínios 0,93 (desesperança), 0,88 (magnificação), 0,86 (ruminação)]. Os coeficientes de correlação item-total variaram 0,91-0,94. Análise fatorial confirmatória apoiou os três fatores de estrutura, com o índice de ajuste comparativo = 0,98, a raiz quadrada média do erro de aproximação = 0,09, e índice de ajuste normalizado = 0,98. Foram encontradas correlações significativas para a intensidade da dor, interferência da dor e humor do paciente (coeficientes de correlação variaram 0,48-0,66, P <0,01). Nas comparações entre grupo controle (pacientes com escores de dor na VAS igual ou inferior a 40 mm na maior parte do dia nos últimos seis meses), e pacientes com condições dolorosas específicas observou-se pontuações mais baixas de catastrofização no grupo controle. No grupo com CTC a relação entre a curva de cortisol salivar, obtida em três pontos do dia (08:00, 16:00 e 22:00 horas) e a catastrofização de acordo com os grupos de catastrofização ( escores B-PCS) estratificados em níveis alto e baixo (alto> Q75 = 42 ou baixo Q75 < 42 ), utilizou-se análise de variância de medidas repetidas (ANOVA), com teste post hoc de Bonferroni. Pacientes com altos escores de catastrofismo apresentaram supressão da secreção de cortisol às 08:00 (p <0,05). Usando modelo multivariado de regressão linear, os fatores correlacionados positivamente com a variável dependente (escores da B-PCS) foram os fatores independentes: níveis séricos de TNF, pontuação no HIT6 e idade (p <0,05). O uso de antidepressivos reduziu em 21% o incremento nos escores da B-PCS. Conclusão: Nossos resultados suportam a validade e confiabilidade da B-PCS. A escala mostrou propriedades psicométricas satisfatórias. A estrutura de três fatores apresentou boas propriedades discriminatórias na comparação de pensamentos catastróficos de sujeitos controles, fibromiálgicos e CTC. A B-PCS mostrou-se instrumento com perfil satisfatório para uso em pesquisa e clínica no Brasil. Também, observamos que a catastrofização está correlacionada com o impacto da CTH, menor oscilação circadiana na secreção de cortisol salivar e níveis séricos de TNF. Isto sugere que o comportamento catastrófico possui substrato biológico que indica sua associação com o estresse crônico e resposta inflamatória. / Theoretical basis: Chronic pain is due to structural and functional changes that influence the maladaptive response to stimuli or processes that underlie excitability. One of the symptoms that permeates large number of patients with chronic pain is the catastrophizing, whose characteristics are a set of negative thoughts, holplessness and magnification of the symptom or condition. This symptom is measured through a catastrophizing scale used in several countries. However, we do not have this instrument for the Portuguese. Objectives: To validate the PCS for Brazil’s Portuguese (B) and verify its psychometric properties. Check the internal consistency, factor structure, and its ability to discriminate patients with specific conditions of chronic pain chronic such as chronic tension type headache (CTH) in accordance with International Headache Society and fibromyalgia according to the criteria of the American College of Rheumatology. To evaluate the possible neurobiological mechanisms correlated with the level of catastrophic symptoms through Cortisol and TNF dosages in a sample of patients with CTH. Methods: 384 subjects aged 18-79 years with chronic musculoskeletal pain participated in this cross-sectional study. The version of the B-PCS was applied as well as pain intensity, pain interference in functional ability, mood and a socio-demographic questionnaire. The discriminatory capacity of B-PCS was assessed in a subsample of patients with chronic tension type headaches (CTH) in accordance with the criteria of the International Headache Society (n = 19), and another with a diagnosis of fibromyalgia according to the criteria of the American College of Rheumatology (n = 50). After the validation the B-PCS was applied in a group of patients with CTH. The impact of headache were evaluated using the Short-Form Headache Impact Test (HIT-6), salivary cortisol samples collected at 08:00, 16:00 and 22:00 and serum TNF. Results: There was good internal consistency [Cronbach's α values of 0.91 for the total PCS-BR. For subdomains 0.93 (holplessness), 0.88 (magnification), 0.86 (rumination)].The coefficients of item-total correlation ranged from .91 to .94. Confirmatory factor analysis supported the three factor structure, with the comparative fit index = 0.98, root mean square error of approximation = 0.09, standard setting and the index of = 0.98. Significant correlations were found for pain intensity, pain interference and mood of the patient (correlation coefficients ranged from .48 to .66, P <0.01). Comparisons between the control group (patients with VAS pain scores at or below 40 mm in most of the day in the last six months), and patients with specific pain conditions were observed lower catastrophizing scores in the control group. In the group with CTH the relationship between the salivary cortisol curve, obtained at three points of the day (08:00, 16:00 and 22:00 hours) and catastrophizing according catastrophizing groups (B-PCS scores) stratified into low and high level (high>Q75=42 or low Q75<42), we used analysis of variance for repeated measures (ANOVA) with Bonferroni post hoc test. Patients with high scores of catastrophism had suppression of cortisol secretion at 08:00 (p <0.05). Using a multivariate linear regression model, the factors positively correlated with the dependent variable (scores of B-PCS) were the independent factors: serum levels of TNF, HIT6 score and age (p <0.05). The use of antidepressants decreased by 21% the increase in scores of B-PCS. Conclusion: Our results support the validity and reliability of the B-PCS. The scale showed satisfactory psychometric properties. The three-factor structure showed good discriminatory properties in comparison to control subjects, fibromyalgia, and HSC catastrophic thoughts. The B-PCS showed to be an instrument with a profile suitable for use in research and clinical practice in Brazil. Also, we found that catastrophizing is correlated with the impact of CTH, lower circadian oscillation in the secretion of salivary cortisol and serum levels of TNF. This suggests that the catastrophic behavior has biological substrate indicating its association with chronic stress and inflammatory response.

Base teórica: A dor crônica decorre de alterações estruturais e funcionais mal adaptativas que influenciam a resposta ao estímulo ou que sustentam os processos de excitabilidade. Um dos sintomas que permeia grande número de pacientes com dor crônica é a catastrofização, cujas características são um conjunto de pensamentos negativos, deseperança e magnificação do sintoma ou condição. Este sintoma é mensurado por meio de uma escala de catastrofização usada em vários países. No entanto não dispomos deste instrumento validado para o português.Objetivos: Validar para o português do Brasil (B) a PCS e verificar suas propriedades psicométricas. Verificar a consistência interna, estrutura fatorial, e sua capacidade de discriminar pacientes com condições específicas de dor crônica como cefaleia tensional crônica (CTC) (International Headache Society) e fibromialgia de acordo com os critérios do American College of Rheumatology. Avaliar os possíveis mecanismos neurobiológicos correlacionados com o nível de sintomas catastróficos, através de dosagens de cortisol e TNF em uma amostra de pacientes com CTC. Métodos: 384 sujeitos com idades entre 18-79 anos com dor crônica de origem músculo-esquelética participaram deste estudo transversal. A versão da B-PCS foi aplicada, assim como a intensidade da dor, interferência da dor na capacidade funcional, no humor e um questionário sócio-demográfico. A capacidade discriminatória da B-PCS foi avaliada numa sub-amostra de pacientes com cefaléia tensional crônica (CTC) de acordo com os critérios da International Headache Society (n = 19), e em outro com diagnóstico de fibromialgia segundo os critérios do American College of Rheumatology (n = 50). Após a validação a B-PCS foi aplicada num grupo de pacientes com CTC. Foi avaliado o impacto da cefaleia usando o Short-Form Headache Impact Test (HIT-6), coletadas amostras de cortisol salivar às 08:00; 16:00 e 22:00 e dosado o TNF sérico. Resultados: Observou-se boa consistência interna [valores α de Cronbach de 0,91 para o total da BR-PCS. Para os subdomínios 0,93 (desesperança), 0,88 (magnificação), 0,86 (ruminação)]. Os coeficientes de correlação item-total variaram 0,91-0,94. Análise fatorial confirmatória apoiou os três fatores de estrutura, com o índice de ajuste comparativo = 0,98, a raiz quadrada média do erro de aproximação = 0,09, e índice de ajuste normalizado = 0,98. Foram encontradas correlações significativas para a intensidade da dor, interferência da dor e humor do paciente (coeficientes de correlação variaram 0,48-0,66, P <0,01). Nas comparações entre grupo controle (pacientes com escores de dor na VAS igual ou inferior a 40 mm na maior parte do dia nos últimos seis meses), e pacientes com condições dolorosas específicas observou-se pontuações mais baixas de catastrofização no grupo controle. No grupo com CTC a relação entre a curva de cortisol salivar, obtida em três pontos do dia (08:00, 16:00 e 22:00 horas) e a catastrofização de acordo com os grupos de catastrofização ( escores B-PCS) estratificados em níveis alto e baixo (alto> Q75 = 42 ou baixo Q75 < 42 ), utilizou-se análise de variância de medidas repetidas (ANOVA), com teste post hoc de Bonferroni. Pacientes com altos escores de catastrofismo apresentaram supressão da secreção de cortisol às 08:00 (p <0,05). Usando modelo multivariado de regressão linear, os fatores correlacionados positivamente com a variável dependente (escores da B-PCS) foram os fatores independentes: níveis séricos de TNF, pontuação no HIT6 e idade (p <0,05). O uso de antidepressivos reduziu em 21% o incremento nos escores da B-PCS. Conclusão: Nossos resultados suportam a validade e confiabilidade da B-PCS. A escala mostrou propriedades psicométricas satisfatórias. A estrutura de três fatores apresentou boas propriedades discriminatórias na comparação de pensamentos catastróficos de sujeitos controles, fibromiálgicos e CTC. A B-PCS mostrou-se instrumento com perfil satisfatório para uso em pesquisa e clínica no Brasil. Também, observamos que a catastrofização está correlacionada com o impacto da CTH, menor oscilação circadiana na secreção de cortisol salivar e níveis séricos de TNF. Isto sugere que o comportamento catastrófico possui substrato biológico que indica sua associação com o estresse crônico e resposta inflamatória. / Theoretical basis: Chronic pain is due to structural and functional changes that influence the maladaptive response to stimuli or processes that underlie excitability. One of the symptoms that permeates large number of patients with chronic pain is the catastrophizing, whose characteristics are a set of negative thoughts, holplessness and magnification of the symptom or condition. This symptom is measured through a catastrophizing scale used in several countries. However, we do not have this instrument for the Portuguese. Objectives: To validate the PCS for Brazil’s Portuguese (B) and verify its psychometric properties. Check the internal consistency, factor structure, and its ability to discriminate patients with specific conditions of chronic pain chronic such as chronic tension type headache (CTH) in accordance with International Headache Society and fibromyalgia according to the criteria of the American College of Rheumatology. To evaluate the possible neurobiological mechanisms correlated with the level of catastrophic symptoms through Cortisol and TNF dosages in a sample of patients with CTH. Methods: 384 subjects aged 18-79 years with chronic musculoskeletal pain participated in this cross-sectional study. The version of the B-PCS was applied as well as pain intensity, pain interference in functional ability, mood and a socio-demographic questionnaire. The discriminatory capacity of B-PCS was assessed in a subsample of patients with chronic tension type headaches (CTH) in accordance with the criteria of the International Headache Society (n = 19), and another with a diagnosis of fibromyalgia according to the criteria of the American College of Rheumatology (n = 50). After the validation the B-PCS was applied in a group of patients with CTH. The impact of headache were evaluated using the Short-Form Headache Impact Test (HIT-6), salivary cortisol samples collected at 08:00, 16:00 and 22:00 and serum TNF. Results: There was good internal consistency [Cronbach's α values of 0.91 for the total PCS-BR. For subdomains 0.93 (holplessness), 0.88 (magnification), 0.86 (rumination)].The coefficients of item-total correlation ranged from .91 to .94. Confirmatory factor analysis supported the three factor structure, with the comparative fit index = 0.98, root mean square error of approximation = 0.09, standard setting and the index of = 0.98. Significant correlations were found for pain intensity, pain interference and mood of the patient (correlation coefficients ranged from .48 to .66, P <0.01). Comparisons between the control group (patients with VAS pain scores at or below 40 mm in most of the day in the last six months), and patients with specific pain conditions were observed lower catastrophizing scores in the control group. In the group with CTH the relationship between the salivary cortisol curve, obtained at three points of the day (08:00, 16:00 and 22:00 hours) and catastrophizing according catastrophizing groups (B-PCS scores) stratified into low and high level (high>Q75=42 or low Q75<42), we used analysis of variance for repeated measures (ANOVA) with Bonferroni post hoc test. Patients with high scores of catastrophism had suppression of cortisol secretion at 08:00 (p <0.05). Using a multivariate linear regression model, the factors positively correlated with the dependent variable (scores of B-PCS) were the independent factors: serum levels of TNF, HIT6 score and age (p <0.05). The use of antidepressants decreased by 21% the increase in scores of B-PCS. Conclusion: Our results support the validity and reliability of the B-PCS. The scale showed satisfactory psychometric properties. The three-factor structure showed good discriminatory properties in comparison to control subjects, fibromyalgia, and HSC catastrophic thoughts. The B-PCS showed to be an instrument with a profile suitable for use in research and clinical practice in Brazil. Also, we found that catastrophizing is correlated with the impact of CTH, lower circadian oscillation in the secretion of salivary cortisol and serum levels of TNF. This suggests that the catastrophic behavior has biological substrate indicating its association with chronic stress and inflammatory response.

Base teórica: A dor crônica decorre de alterações estruturais e funcionais mal adaptativas que influenciam a resposta ao estímulo ou que sustentam os processos de excitabilidade. Um dos sintomas que permeia grande número de pacientes com dor crônica é a catastrofização, cujas características são um conjunto de pensamentos negativos, deseperança e magnificação do sintoma ou condição. Este sintoma é mensurado por meio de uma escala de catastrofização usada em vários países. No entanto não dispomos deste instrumento validado para o português.Objetivos: Validar para o português do Brasil (B) a PCS e verificar suas propriedades psicométricas. Verificar a consistência interna, estrutura fatorial, e sua capacidade de discriminar pacientes com condições específicas de dor crônica como cefaleia tensional crônica (CTC) (International Headache Society) e fibromialgia de acordo com os critérios do American College of Rheumatology. Avaliar os possíveis mecanismos neurobiológicos correlacionados com o nível de sintomas catastróficos, através de dosagens de cortisol e TNF em uma amostra de pacientes com CTC. Métodos: 384 sujeitos com idades entre 18-79 anos com dor crônica de origem músculo-esquelética participaram deste estudo transversal. A versão da B-PCS foi aplicada, assim como a intensidade da dor, interferência da dor na capacidade funcional, no humor e um questionário sócio-demográfico. A capacidade discriminatória da B-PCS foi avaliada numa sub-amostra de pacientes com cefaléia tensional crônica (CTC) de acordo com os critérios da International Headache Society (n = 19), e em outro com diagnóstico de fibromialgia segundo os critérios do American College of Rheumatology (n = 50). Após a validação a B-PCS foi aplicada num grupo de pacientes com CTC. Foi avaliado o impacto da cefaleia usando o Short-Form Headache Impact Test (HIT-6), coletadas amostras de cortisol salivar às 08:00; 16:00 e 22:00 e dosado o TNF sérico. Resultados: Observou-se boa consistência interna [valores α de Cronbach de 0,91 para o total da BR-PCS. Para os subdomínios 0,93 (desesperança), 0,88 (magnificação), 0,86 (ruminação)]. Os coeficientes de correlação item-total variaram 0,91-0,94. Análise fatorial confirmatória apoiou os três fatores de estrutura, com o índice de ajuste comparativo = 0,98, a raiz quadrada média do erro de aproximação = 0,09, e índice de ajuste normalizado = 0,98. Foram encontradas correlações significativas para a intensidade da dor, interferência da dor e humor do paciente (coeficientes de correlação variaram 0,48-0,66, P <0,01). Nas comparações entre grupo controle (pacientes com escores de dor na VAS igual ou inferior a 40 mm na maior parte do dia nos últimos seis meses), e pacientes com condições dolorosas específicas observou-se pontuações mais baixas de catastrofização no grupo controle. No grupo com CTC a relação entre a curva de cortisol salivar, obtida em três pontos do dia (08:00, 16:00 e 22:00 horas) e a catastrofização de acordo com os grupos de catastrofização ( escores B-PCS) estratificados em níveis alto e baixo (alto> Q75 = 42 ou baixo Q75 < 42 ), utilizou-se análise de variância de medidas repetidas (ANOVA), com teste post hoc de Bonferroni. Pacientes com altos escores de catastrofismo apresentaram supressão da secreção de cortisol às 08:00 (p <0,05). Usando modelo multivariado de regressão linear, os fatores correlacionados positivamente com a variável dependente (escores da B-PCS) foram os fatores independentes: níveis séricos de TNF, pontuação no HIT6 e idade (p <0,05). O uso de antidepressivos reduziu em 21% o incremento nos escores da B-PCS. Conclusão: Nossos resultados suportam a validade e confiabilidade da B-PCS. A escala mostrou propriedades psicométricas satisfatórias. A estrutura de três fatores apresentou boas propriedades discriminatórias na comparação de pensamentos catastróficos de sujeitos controles, fibromiálgicos e CTC. A B-PCS mostrou-se instrumento com perfil satisfatório para uso em pesquisa e clínica no Brasil. Também, observamos que a catastrofização está correlacionada com o impacto da CTH, menor oscilação circadiana na secreção de cortisol salivar e níveis séricos de TNF. Isto sugere que o comportamento catastrófico possui substrato biológico que indica sua associação com o estresse crônico e resposta inflamatória. / Theoretical basis: Chronic pain is due to structural and functional changes that influence the maladaptive response to stimuli or processes that underlie excitability. One of the symptoms that permeates large number of patients with chronic pain is the catastrophizing, whose characteristics are a set of negative thoughts, holplessness and magnification of the symptom or condition. This symptom is measured through a catastrophizing scale used in several countries. However, we do not have this instrument for the Portuguese. Objectives: To validate the PCS for Brazil’s Portuguese (B) and verify its psychometric properties. Check the internal consistency, factor structure, and its ability to discriminate patients with specific conditions of chronic pain chronic such as chronic tension type headache (CTH) in accordance with International Headache Society and fibromyalgia according to the criteria of the American College of Rheumatology. To evaluate the possible neurobiological mechanisms correlated with the level of catastrophic symptoms through Cortisol and TNF dosages in a sample of patients with CTH. Methods: 384 subjects aged 18-79 years with chronic musculoskeletal pain participated in this cross-sectional study. The version of the B-PCS was applied as well as pain intensity, pain interference in functional ability, mood and a socio-demographic questionnaire. The discriminatory capacity of B-PCS was assessed in a subsample of patients with chronic tension type headaches (CTH) in accordance with the criteria of the International Headache Society (n = 19), and another with a diagnosis of fibromyalgia according to the criteria of the American College of Rheumatology (n = 50). After the validation the B-PCS was applied in a group of patients with CTH. The impact of headache were evaluated using the Short-Form Headache Impact Test (HIT-6), salivary cortisol samples collected at 08:00, 16:00 and 22:00 and serum TNF. Results: There was good internal consistency [Cronbach's α values of 0.91 for the total PCS-BR. For subdomains 0.93 (holplessness), 0.88 (magnification), 0.86 (rumination)].The coefficients of item-total correlation ranged from .91 to .94. Confirmatory factor analysis supported the three factor structure, with the comparative fit index = 0.98, root mean square error of approximation = 0.09, standard setting and the index of = 0.98. Significant correlations were found for pain intensity, pain interference and mood of the patient (correlation coefficients ranged from .48 to .66, P <0.01). Comparisons between the control group (patients with VAS pain scores at or below 40 mm in most of the day in the last six months), and patients with specific pain conditions were observed lower catastrophizing scores in the control group. In the group with CTH the relationship between the salivary cortisol curve, obtained at three points of the day (08:00, 16:00 and 22:00 hours) and catastrophizing according catastrophizing groups (B-PCS scores) stratified into low and high level (high>Q75=42 or low Q75<42), we used analysis of variance for repeated measures (ANOVA) with Bonferroni post hoc test. Patients with high scores of catastrophism had suppression of cortisol secretion at 08:00 (p <0.05). Using a multivariate linear regression model, the factors positively correlated with the dependent variable (scores of B-PCS) were the independent factors: serum levels of TNF, HIT6 score and age (p <0.05). The use of antidepressants decreased by 21% the increase in scores of B-PCS. Conclusion: Our results support the validity and reliability of the B-PCS. The scale showed satisfactory psychometric properties. The three-factor structure showed good discriminatory properties in comparison to control subjects, fibromyalgia, and HSC catastrophic thoughts. The B-PCS showed to be an instrument with a profile suitable for use in research and clinical practice in Brazil. Also, we found that catastrophizing is correlated with the impact of CTH, lower circadian oscillation in the secretion of salivary cortisol and serum levels of TNF. This suggests that the catastrophic behavior has biological substrate indicating its association with chronic stress and inflammatory response.

No description available.

No description available.