Thesis The association between pain catastrophizing and chronic fatigue in the general population: the HUNT pain study, 2023, Schjetne

https://ntnuopen.ntnu.no/ntnu-xmlui/handle/11250/3080846

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https://hdl.handle.net/11250/3080846
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2023
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• Institutt for sirkulasjon og bildediagnostikk [1697]

The association between pain catastrophizing and chronic fatigue in the general population: the HUNT pain study
Schjetne, Julie
Master thesis

Abstract

Introduction: Fatigue and pain are common complaints in the community and may have many of the same underlying mechanisms. Pain catastrophizing is a predictor of adverse pain-related outcomes, but the relation to fatigue is not fully investigated. The aim of this study is to firstly investigate the association between pain catastrophizing and feeling of energy in the general population and the second aim is to see if pain catastrophizing is related to the occurrence of chronic fatigue.


Method: In the population-based HUNT pain study, a random sample of 6419 participants were invited to answer questions about how much energy they had during the last week, using the SF-8 vitality scale, every three months over a year. Multiple linear regression and logistic regression analyses were used to investigate the association between pain catastrophizing and individuals’ tendency to report energy over one year, and the association with chronic fatigue, respectively. Chronic fatigue was defined as a mean score of less than 2 which indicates reports of a little energy or less most of the time.


Results: The current sample (n=3965) consisted of individuals answering about the required variables and possible confounders. A significant association was found between pain catastrophizing and energy levels of the general population even after controlling for age, sex, organ-specific diseases, mental health, and pain intensity (β=0.04, 95% CI: 0.03-0.05). In the general population, 10% was defined as having chronic fatigue and odds increasing by 1.2 (95% CI: 1.1-1.3) for every unit increase in pain catastrophizing.


Conclusion: This study indicates that there is an association between pain catastrophizing and energy levels, and the association is even more apparent with chronic fatigue. According to models explaining fatigue and pain, pain catastrophizing may strengthen an imbalance of costs versus benefits in goal-directed behaviour. Moreover, it is proposed that fatigue can be included in the vicious circle described by the fear-avoidance model as a consequence of catastrophizing and maintaining pain.

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NTNU

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Introduksjon: Utmattelse og smerte er utbredte plager i samfunnet og kan ha mange av de samme underliggende mekanismene. Verstefallstenkning om smerte er en prediktor for negative smerterelaterte konsekvenser, men sammenhengen med utmattelse er ikke fullstendig undersøkt. Det første formålet med studien er å undersøke sammenhengen mellom verstefallstekning om smerte og følelsen av overskudd i den generelle befolkningen, og det andre formålet er å se om verstefallstenkning om smerte er relatert til forekomsten av kronisk utmattelse.



Metode: I den populasjonsbaserte studien smerte-HUNT ble et tilfeldig utvalg på 6419 deltagere invitert til å svare på spørsmål om hvor mye overskudd de hadde siste uken, ved bruk av SF-8 vitalitetsskala, hver tredje måned over ett år. Multiple lineære og logiske regresjonsanalyser ble brukt for å undersøke henholdsvis sammenhengen mellom verstefallstenkning og personers tendens til å rapportere overskudd over ett år, og assosiasjonen med kronisk utmattelse. Kronisk utmattelse ble definert som en gjennomsnittsscore på mindre enn 2 som indikerer rapportering av litt overskudd eller mindre over tid.


Resultater: Utvalget i studien (n=3965) bestod av personer som hadde svart på de nødvendige variablene og mulige konfundere. Det ble funnet en signifikant sammenheng mellom verstefallstenkning om smerte og overskudd i den generelle befolkningen, selv etter å ha kontrollert for alder, kjønn, organspesifikke sykdommer, mental helse og smerteintensitet (β=0.04, 95% CI: 0.03-0.05). I den generelle befolkningen ble 10% definert som å ha kronisk utmattelse og odds økende med 1.2 (95% CI: 1.1-1.3) for hver enhet økning i verstefallstenkning om smerte.


Konklusjon: Denne studien indikerer at det er en sammenheng mellom verstefallstekning om smerte og overskudd, og sammenhengen er enda mer tydelig med kronisk utmattelse. Ifølge forklaringsmodeller for utmattelse og smerte kan verstefalltenkning om smerte mulig forsterke ubalansen mellom kostnader og nytte i målrettet adferd. Det foreslåes at utmattelse kan inkluderes i den onde sirkelen beskrevet i frykt-unngåelsesmodellen som en konsekvens av verstefallstenking og opprettholdelse av smerte.

 

It seems that the authors assume being in pain = pain catastrophizing.

They are not even looking at correlations (which don't imply causation anyway) they are looking at associations.

Being in pain is exhausting, so no wonder it causes fatigue.

I've thought many times that the people doing this type of research have never been in more pain than would occur after stubbing your toe on a pillow.

 

I can't believe that some Master's degrees can be gotten this easily. It degrades the value for everyone who actually had to put some effort into it. Pain catastrophizing is completely subjective to a 3rd party, has zero value and is nothing but a moral judgment of other people's behavior.

 

Anyone who writes about pain catastrophizing deserves a cat ass trophy.

 

Masters level work shouldn’t be published any more than undergraduate essays are. It’s a passport to doctoral research, not a purported contribution to human understanding, and of course it looks woefully threadbare to anyone with a longstanding interest in the subject at hand.

I would definitely agree that the supervisor deserves more blame than the author, but the institution and the publisher shouldn’t be doing this for anything dashed off by a callow youngster a year into postgraduate study, even on subjects which are less contentious. In a few years this poor sod will be trying to get a proper job somewhere, with theor youthful witterings - and online critiques - visible for all to see.

 

* applauds *

 

Well, I hope there is an erasure provision under GDPR. If anything deserves to be forgotten, it is juvenilia.

 

Sorry. No idea..

 

That last point is definitely a solid public interest argument.