To what extent are cognitive mechanisms of negative emotional experience in
depression and other psychopathology similar or identical to cognitive mechanisms
that determine the affective response to immediate sensory experience, in
particular, pain? Cognitive vulnerability-stress theories of depression (Abramson et
al., 2002) posit a model wherein experiences (i.e. stimuli of various sorts) are
processed through a “negative cognitive style” which leads to symptoms of
depression, including negative affect. In the absence of the negative cognitive style,
the cognitive processing of the same stimulus could lead to less negative affect.
Similarly, pain catastrophizing theory suggests that nociceptive stimuli, when
processed through the cognitive style of catastrophizing , leads to increases in
severity of pain, as well as negative affect and life impairment (Edwards, Bingham,
Bathon, & Haythornthwaite, 2006). Appraisal theories of emotion suggest that the
fundamental process of emotion is a cognitive appraisal of experience, which leads
to the resulting emotion (Roseman & Smith, 2001). Finally, mindfulness meditationbased interventions such as Mindfulness Based Stress Reduction (MBSR) are based
on a similar framework, in which the aversive quality of any experience is enhanced,
or in some cases created entirely, by elaborative or ruminative processes that build
on the sensory and primary affective response to the aversive stimulus (Kabat-Zinn,
1982).
There are clear parallels among all these areas. Presently we address the relation
specifically between pain perception and cognitive models of depression. Previous
research on pain catastrophizing has relied primarily on assessment using the Pain
Catastrophizing Scale, a short questionnaire designed to measure catastrophizing
and believed to consist of three factors: magnification, rumination, and helplessness
(Edwards et al., 2006). In order to more closely examine the relationship between
cognitive factors in pain perception and cognitive factors in the development of
depression, we propose to create a variation of the Cognitive Style Questionnaire
(CSQ) (Alloy et al., 2000) specific to pain experience. The existing CSQ has
subsections for cognitive style in two areas of life: achievement, and interpersonal;
we will create a third for pain experiences. We hope to test this scale, together with
the PCS and other measures of depression, anxiety and quality of life, in an
upcoming large-scale, longitudinal study of the MBSR intervention.
References
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