{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:01:45Z","timestamp":1790949705976,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,4,3]],"date-time":"2017-04-03T00:00:00Z","timestamp":1491177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Spinnaker Health Research Foundation"},{"name":"Bellberry Medical Research Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["British J Health Psychol"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pain catastrophizing is widely studied in quantitative pain research because of its strong link with poor pain outcomes, although the exact nature of this construct remains unclear. Focusing on its ruminative dimension, the present qualitative study aimed to explore a nascent aspect of pain catastrophizing \u2013 metacognition \u2013 by documenting people's attitudes towards rumination and examining how these metacognitions might influence the course it takes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative interview study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi\u2010structured interviews were conducted in a tertiary care setting with 15 adults experiencing chronic (\u22656\u00a0months) low back pain who scored highly (\u226530) on the Pain Catastrophising Scale. Transcripts were analysed using interpretative phenomenological analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The first aim of documenting pain metacognitions revealed both positive (e.g., \u2018thinking helps me to cope\u2019) and negative (e.g., \u2018rumination is uncontrollable\u2019) attitudes towards pain rumination. These were often held simultaneously, creating internal conflict. The second aim of exploring the influence of metacognition on rumination showed that both negative and positive metacognitions could fuel perseverative thinking. However, more nuanced negative metacognitions (e.g., \u2018worry is pointless\u2019) could help to end episodes of rumination by motivating the use of concrete problem\u2010solving or active coping behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While most participants described pain rumination as uncontrollable and harmful, dwelling on pain could be helpful when focused on tangible and solvable problems, thereby translating into adaptive coping behaviours that eventually interrupt rumination. Future treatments may be more effective if they are based on individualized formulations of pain catastrophizing that focus on its perseverative nature and implicit function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                        <jats:caption>\n                          <jats:title>Statement of contribution<\/jats:title>\n                        <\/jats:caption>\n                        <jats:p>\n                          <jats:italic>\n                            <jats:bold>What is already known on this subject?<\/jats:bold>\n                          <\/jats:italic>\n                        <\/jats:p>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>Chronic pain affects one in five people, and psychological coping responses are key targets within gold standard biopsychosocial interventions.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>People who have elevated pain catastrophizing tend to have worse pain outcomes, including increased pain, disability, and emotional distress.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>What people believe about their own thinking (i.e., their metacognitions) influences how much they worry or ruminate.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                        <jats:p>\n                          <jats:italic>\n                            <jats:bold>What does this study add?<\/jats:bold>\n                          <\/jats:italic>\n                        <\/jats:p>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>This is the first qualitative study exploring metacognitions in people with chronic pain and the first to target a purposive sample of people with elevated pain catastrophizing.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>People with elevated pain catastrophizing often see rumination as uncontrollable and harmful but may simultaneously believe it helps them to solve problems or feel prepared for future threats.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Pain catastrophizing is not a stable and enduring trait but fluctuates both within and across individuals in response to pain, context, metacognitive beliefs about rumination, and coping behaviours.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.12240","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T11:20:23Z","timestamp":1491391223000},"page":"463-480","source":"Crossref","is-referenced-by-count":26,"title":["\u2018I call it stinkin\u2019 thinkin\u2019\u2019: A qualitative analysis of metacognition in people with chronic low back pain and elevated catastrophizing"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-2569","authenticated-orcid":false,"given":"Robert","family":"Sch\u00fctze","sequence":"first","affiliation":[{"name":"School of Psychology and Speech Pathology Curtin University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Rees","sequence":"additional","affiliation":[{"name":"School of Psychology and Speech Pathology Curtin University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Slater","sequence":"additional","affiliation":[{"name":"School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Smith","sequence":"additional","affiliation":[{"name":"School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"School of Physiotherapy and Exercise Science Curtin University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102015\u2010008847"},{"key":"e_1_2_8_3_1","first-page":"129","article-title":"Pain assessment: Global use of the brief pain inventory","volume":"23","author":"Cleeland C. S.","year":"1994","journal-title":"Annals of the Academy of Medicine, Singapore"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200001000-00004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.04.027"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e318287a1dc"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532\u20102149.2012.00136.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.09.014"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2011.2"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532\u20102149.2012.00252.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203881477"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2010.02.003"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2013.769621"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12671\u2010012\u20100169\u20103"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000139"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5055\u201013.2014"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253\u20107176.106012"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2013.10.014"},{"key":"e_1_2_8_19_1","volume-title":"Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms","author":"Merskey H.","year":"1994"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.05.005"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.689"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22273"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sjpain.2014.04.004"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794112446106"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/204946371000400102"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/14780880701826143"},{"key":"e_1_2_8_27_1","unstructured":"QSR International(2014).NVivo for Mac qualitative data analysis software."},{"key":"e_1_2_8_28_1","volume-title":"Qualtrics research suite","author":"Qualtrics","year":"2013"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1586\/ern.09.34"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/cp.12105"},{"key":"e_1_2_8_31_1","volume-title":"Mindfulness\u2010based cognitive therapy for depression","author":"Segal Z. V.","year":"2013"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2005.10.011"},{"key":"e_1_2_8_33_1","volume-title":"Interpretative phenomenological analysis: Theory, method and research","author":"Smith J. A.","year":"2009"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/14768320600941756"},{"key":"e_1_2_8_35_1","first-page":"53","volume-title":"Qualitative psychology: A practical guide to research methods","author":"Smith J. A.","year":"2008"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2011.630734"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/cp.12081"},{"key":"e_1_2_8_38_1","volume-title":"The pain catastrophizing scale: User manual","author":"Sullivan M. J.","year":"2004"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040\u20103590.7.4.524"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304\u20103959(00)00430\u20109"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200103000-00008"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.10.281"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_8_44_1","first-page":"2","volume-title":"Psychological approaches to pain management: A practitioner's handbook","author":"Turk D. C.","year":"2002"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200103000-00009"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000635"},{"key":"e_1_2_8_47_1","volume-title":"Rumination\u2010focused cognitive\u2010behavioral therapy for depression","author":"Watkins E. R.","year":"2016"},{"key":"e_1_2_8_48_1","volume-title":"Emotional disorders and metacognition: Innovative cognitive therapy","author":"Wells A.","year":"2000"},{"key":"e_1_2_8_49_1","volume-title":"Metacognitive therapy for anxiety and depression","author":"Wells A.","year":"2009"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005\u20107967(03)00147\u20105"},{"key":"e_1_2_8_51_1","volume-title":"Attention and emotion: A clinical perspective","author":"Wells A.","year":"1994"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005\u20107967(96)00050\u20102"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2014.03.003"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007407.pub3"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744\u2010859X\u20107\u20104"}],"container-title":["British Journal of Health Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbjhp.12240","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjhp.12240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T11:11:53Z","timestamp":1761736313000},"score":1,"resource":{"primary":{"URL":"https:\/\/bpspsychub.onlinelibrary.wiley.com\/doi\/10.1111\/bjhp.12240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,3]]},"references-count":54,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,9]]}},"alternative-id":["10.1111\/bjhp.12240"],"URL":"https:\/\/doi.org\/10.1111\/bjhp.12240","archive":["Portico"],"relation":{},"ISSN":["1359-107X","2044-8287"],"issn-type":[{"value":"1359-107X","type":"print"},{"value":"2044-8287","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,3]]}}}