{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T18:43:03Z","timestamp":1785609783444,"version":"3.56.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":306,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 NS045549"],"award-info":[{"award-number":["T32 NS045549"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although pain catastrophizing has been studied widely, there is no consensus on what constitutes an exaggerated response, that is, true catastrophizing, from what might be proportional unpleasant or negative responses to pain. Most available catastrophizing assessments ask respondents to consider when \u201cin pain,\u201d with no assessment of these referent pain anchors. Thus, the influence of referent pain on catastrophic thinking remains unclear. We aimed to assess consistency across referent pain scenarios and to characterize \u201chigh\u201d catastrophizing\u2014representing exaggerated responses relative to referent pain intensity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 228 adults (152F) completed this observational study. The Pain Catastrophizing Scale (PCS) was completed 4 times interspersed with other assessments. First, with standard instructions, then with specific referent scenarios in a blocked order to minimize order effects. Anticipated scenario pain intensities were rated using a 0\u201310\u2010cm scale. PCS cross\u2010situational consistency was assessed with intraclass correlations. Mixed linear models evaluated the PCS\u2014referent pain relationship, with and without covariate adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PCS cross\u2010situational consistency was high, with ICCs\u2009=\u20090.79\u20130.84. However, total scores varied significantly across referent scenarios, where catastrophizing generally increased with referent pain intensity (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.74,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), and pain explained 40% of PCS variability. The best fit model of \u201chigh\u201d catastrophizing, using the 75th percentile, varied with referent pain intensity, underscoring the importance of contextual anchors, without notable sex differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Trait PCS scores should not be interpreted as context\u2010free indices of catastrophizing. The wide range of published PCS cut points may in part reflect differences in referent pain, highlighting the need to contextualize catastrophizing scores for appropriate interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/prm\/8839902","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T07:06:28Z","timestamp":1762239988000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["When Pain Catastrophizing Is Not Catastrophizing: Identifying Normative From Exaggerated Responses Relative to Referent Pain Intensity"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3574-3715","authenticated-orcid":false,"given":"Laura A.","family":"Frey-Law","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2365-7211","authenticated-orcid":false,"given":"Jennifer E.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1769-2966","authenticated-orcid":false,"given":"Adam","family":"Janowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.11.003"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1586\/ern.09.34"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200103000-00008"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001939"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.603420"},{"key":"e_1_2_11_6_2","volume-title":"The Pain Catastrophizing Scale: User Manual","author":"Sullivan M. 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