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While previous neuroimaging studies have focused on evoked pain response modulation by catastrophizing, the brain mechanisms supporting pain catastrophizing itself are unknown. We designed a functional magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">fMRI<\/jats:styled-content>)\u2013based pain catastrophizing task whereby patients with chronic pain engaged in catastrophizing\u2010related cognitions. We undertook this study to test our hypothesis that catastrophizing about clinical pain would be associated with amplified activation in nodes of the default mode network (<jats:styled-content style=\"fixed-case\">DMN<\/jats:styled-content>), which encode self\u2010referential cognition and show altered functioning in chronic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>During <jats:styled-content style=\"fixed-case\">fMRI<\/jats:styled-content>, 31 <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> patients reflected on how catastrophizing (<jats:styled-content style=\"fixed-case\">CAT<\/jats:styled-content>) statements (drawn from the Pain Catastrophizing Scale) impact their typical <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> pain experience. Response to <jats:styled-content style=\"fixed-case\">CAT<\/jats:styled-content> statements was compared to response to matched neutral (<jats:styled-content style=\"fixed-case\">NEU<\/jats:styled-content>) statements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During statement reflection, higher <jats:styled-content style=\"fixed-case\">fMRI<\/jats:styled-content> signal during <jats:styled-content style=\"fixed-case\">CAT<\/jats:styled-content> statements than during <jats:styled-content style=\"fixed-case\">NEU<\/jats:styled-content> statements was found in several <jats:styled-content style=\"fixed-case\">DMN<\/jats:styled-content> brain areas, including the ventral (posterior) and dorsal (anterior) posterior cingulate cortex (<jats:styled-content style=\"fixed-case\">vPCC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">dPCC<\/jats:styled-content>, respectively). Patients\u2019 ratings of <jats:styled-content style=\"fixed-case\">CAT<\/jats:styled-content> statement applicability were correlated solely with activity in the <jats:styled-content style=\"fixed-case\">vPCC<\/jats:styled-content>, a main <jats:styled-content style=\"fixed-case\">DMN<\/jats:styled-content> hub supporting self\u2010referential cognition (r = 0.38, <jats:italic>P<\/jats:italic> &lt; 0.05). Clinical pain severity was correlated solely with activity in the <jats:styled-content style=\"fixed-case\">dPCC<\/jats:styled-content>, a <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> subregion associated with cognitive control and sensorimotor processing (r = 0.38, <jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These findings provide evidence that the <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> encodes pain catastrophizing in <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> and suggest distinct roles for different <jats:styled-content style=\"fixed-case\">PCC<\/jats:styled-content> subregions. Understanding the brain circuitry encoding pain catastrophizing in <jats:styled-content style=\"fixed-case\">FM<\/jats:styled-content> will prove to be important in identifying and evaluating the success of interventions targeting negative affect in chronic pain management.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40507","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T15:17:06Z","timestamp":1522077426000},"page":"1308-1318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Encoding of Self\u2010Referential Pain Catastrophizing in the Posterior Cingulate Cortex in Fibromyalgia"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4424-175X","authenticated-orcid":false,"given":"Jeungchan","family":"Lee","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital 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