The International Association for the Study of Pain (IASP) defines chronic pain as: “Persistent pain, which can be continuous or recurring, whose duration and intensity are sufficient to adversely affect the well-being of a patient, their level of functionality and quality of life”. Chronic pain is a global health problem, affecting between 15-25% of adult population, even increasing up to 50% for geriatric population over 65 years old. In the 1960s, the term “catastrophizing” was used to describe a mal-adaptive cognitive style employed by patients with anxiety and depressive disorders, for example, Beck (1967) described the catastrophe as a "cognitive distortion" that could contribute to the development or exacerbation of depression symptoms. Sullivan et al. in 1995developed the Pain catastrophizing Scale (PCS) in effort to obtain a comprehensive assessment instrument that would cover different perspectives. The catastrophizing is currently defined as: An irrational negative mental forecast of future events, during the actual or anticipated painful experience. Individuals vary the way to express or display experience of pain. When people express pain through multiple behaviors, they are likely to attract the attention of other people in their social environment. It is only through clear communication of distress that others in your social setting will be able to determine that assistance is necessary. Cognitive restructuring is the typical strategy to reduce dysfunctional thinking. This approach centers on identifying automatic and maladaptive cognitions and replacing them with more rational and realistic thoughts (Beck, 1995). As a result of catastrophic patients’ observation, it is noted that exaggerated signs of pain they express may result in an unstable, but sustainable balance between fulfill the support needs and the increasing in pain-related distress. Recent neuroimaging studies have shown that brain areas responsible for attention modulation are more likely to be activated in catastrophic pain experiences. Creating strategies and considering these aspects in the management of patients with chronic pain is responsibility of professionals in order to provide optimal treatment and understanding.
