Pain Catastrophizing and EEG-Alpha Asymmetry

Objectives: Pain catastrophizing is thought to play a causal role in the development and maintenance of chronic pain and its negative impact on functioning. However, few studies have examined the factors that might contribute to the development and maintenance of catastrophizing. The anterior asymmetry and emotion (AAE) model hypothesizes that more activity in left anterior brain regions is associated with a tendency to engage in approach responses (often, but not always, associated with positive valance), and that more right anterior activity is associated with a tendency to engage in more withdrawal responses (often associated with negative valance). Given the consistent associations found between catastrophizing and both (1) approach vs avoidance pain coping styles and (2) affective responses to pain, the AAE model would predict that more left (versus right) anterior brain activity would prospectively predict future catastrophizing. Methods: Anterior asymmetry measures computed using electroencephalogram data from 30 individuals with spinal cord injury were correlated with catastrophizing scores obtained two years after the EEG recording. Results: Consistent with the AAE model, anterior asymmetry scores reflecting greater left than right anterior activity were negatively associated with subsequent catastrophizing. Conclusions: The study findings identify a biological factor that may be associated with greater vulnerability to pain-related catastrophizing. If replicated in future research, the findings suggest new possibilities for treating catastrophizing, which may then contribute to improved pain treatment outcomes.