The Mediating Role of Pain Catastrophizing in Functioning and Mental Health for Youth With Pain-predominant Disorders of Gut–Brain Interaction

OBJECTIVE: This study aimed to identify if pain catastrophizing is a mediator between pain intensity and functioning (functional disability and sleep), as well as mental health (anxiety and depression) in patients with pain-predominant disorders of gut-brain interaction (DGBI). BACKGROUND: Pediatric pain is a significant problem that can lead to impairment in functioning and mental health. It is well documented in the pediatric literature that greater pain severity, pain catastrophizing, anxiety, depression, and reduced functioning are correlated. In youth with pain-predominant DGBI, the exact nature of how pain catastrophizing impacts functioning and mental health is less studied. METHODS: A retrospective review of de-identified data collected as part of clinical care for pediatric patients attending a neurogastroenterology subspecialty clinic was completed. RESULTS: Mediation analyses demonstrated that pain catastrophizing was a significant mediator in the relationships between pain intensity and functional disability, depression, and anxiety. Pain catastrophizing was not a mediator in the relationship between pain intensity and sleep disturbances. CONCLUSIONS: Pain catastrophizing represents a malleable cognitive factor of the pain experience. Clinical intervention on pain catastrophizing appraisals has the potential to improve functioning and mental health, even if pain intensity remains unchanged.