One of the most successful at the time was automatic negative thoughts. There are different levels of cognitive processing, depending on the degree of awareness at the moment they take place. The rationale is that these processes govern our interpretation of reality and, consequently, regulate our emotions and behavior. It has been almost four decades since cognitive processes were incorporated into psychological interventions of chronic pain, specifically through what is known as cognitive-behavioral therapy (1). La catastrofización es variable clave para entender el efecto nocivo de los pensamientos automáticos negativos en la intensidad del dolor crónico, reforzando su papel como diana de los tratamientos, especialmente psicológicos, y avalando la teoría de que más que la presencia o la frecuencia de los pensamientos, es la relación de la persona con los mismos, en términos de credibilidad, la que tiene efecto en la percepción del dolor. Solo un tipo de pensamientos negativos, los de falta de control del dolor, tuvo, además una asociación directa. Controlando el efecto de distintas variables sociodemográficas, se produjo una mediación total de la catastrofización en la asociación de los pensamientos automáticos negativos y la intensidad del dolor, alcanzando porcentajes de varianza explicada de entre el 22% y el 26%. Estudio transversal ex postfacto con trece análisis de mediación simple (PROCESS para SPSS v3.5 con 10.000 muestras bootstrap y 95% de intervalo de confianza) con otros tantos tipos de pensamientos negativos como predictores, la catastrofización como variable mediadora y la intensidad del dolor como variable de resultado. Doscientos veintiocho pacientes de dolor crónico atendidos en tres centros públicos de la provincia de Sevilla. Hipotetizamos que la catastrofización mediaría totalmente la asociación entre los pensamientos automáticos negativos y la intensidad del dolor. Sin embargo, se requieren todavía análisis precisos de cómo estas variables se asocian. Existe evidencia de la asociación de los pensamientos automáticos negativos y la catastrofización en la intensidad del dolor crónico. Catastrophizing turns out to be the key variable to understand the harmful effect of negative automatic thoughts on the intensity of chronic pain, reinforcing its role as a target for treatments, especially psychological ones, and supporting the theory that more than the presence or frequency of the thoughts, it is the relationship of the person with them, in terms of credibility, which has an effect on the perception of pain. Only one type of negative thoughts, those of lack of control, also had a direct association. Controlling the effect sociodemographic variables, there was a total mediation of catastrophizing in the association of negative automatic thoughts and pain intensity, reaching percentages of explained variance of between 22% and 26%. Ex post-facto cross-sectional study with thirteen simple mediation analyses (PROCESS for SPSS v3.5 with 10,000 bootstrap samples and 95% confidence interval) with thirteen types of negative thoughts as predictors, catastrophizing as mediator and pain intensity as the criterion. Two hundred and twenty-eight chronic pain patients treated in three public centres in the province of Seville. We hypothesized that catastrophizing would fully mediate the association between negative automatic thoughts and pain intensity. However, precise analyses of how these variables are associated are still required. There is evidence of the influence of negative automatic thoughts and catastrophizing on chronic pain intensity.
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