Which Types of Rumination Will Predict Longitudinal Physical and Psychological Status in Patients with Chronic Pain?

Rumination is a multidimensional construct, defined as a perseverative cognitive style focusing on negative content. Rumination on emotionally disturbing events has shown a moderate relationship with greater emotional distress in patients with depression. Rumination on pain has also shown a moderate relationship with greater physical and emotional distress in patients with chronic pain. Recently, general rumination tendency which is not specific to a certain content has gained attention. The current study was designed to identify which types of rumination would predict physical and psychological status 3 months later in patients with chronic pain. The Ruminative Thought Style Questionnaire (RTSQ), Ruminative Response Style (RRS), and Rumination subscale of the Pain Catastrophizing Scale (PCS-rumination) were administered to assess the general, negative emotion, and pain rumination, respectively. The PROMIS-physical and psychological measures were administered to assess physical and emotional distress. A total of 129 participants completed the surveys (Mage=53.8, SDage=16.8 years, 80% female). Step-wise regression analyses revealed that PCS-rumination scores significantly predicted worse pain interference, average pain, fatigue, and physical function. The RRS scores significantly predicted worse fatigue. The RTSQ scores did not predict any health status. Interestingly, none of the rumination measures predicted sleep disturbance. In predicting psychological health, the RRS and PCS-rumination scores significantly predicted worse depression. The RRS, PCS-Rumination, and RTSQ scores significantly predicted anxiety. In summary, we found pain rumination as a significant predictor for physical health and negative emotion rumination as a significant predictor for psychological health in patients with chronic pain. Funded by NIH (K23DA048972).