Does acceptance of pain mediate the relation of catastrophism with psychological distress in patients with endometriosis?

Objectives: Both acceptance of pain and pain-related catastrophism have been associated to psychological distress (PD) in patients with chronic pain. Previous research also reported on positive relations between acceptance and catastrophism. These findings may suggest a mediational interplay between acceptance and catastrophism to explain PD. Accordingly, the present study explored whether catastrophism would mediate the relation of acceptance with PD in a sample of women with endometriosis. Methods: 294 women with endometriosis participated in the study. Participants completed self-report measures to assess pain acceptance, pain-related catastrophism, and PD. A series of hierarchical regression analyses were conducted to explore the mediational hypothesis. Results: Acceptance significantly predicted both PD, and catastrophism, even when potential confounders were controlled. Moreover, when both acceptance and catastrophism were put into the same equation, the effect size of acceptance significantly decreased. Conclusions: Findings suggest that low acceptance of pain partially mediates the relationship of catastrophism with PD. In other words, acceptance is one of the mechanism through which catastrophism relates with higher PD.