This study aims to examine the effects of a cognitive restructuring intervention and acceptance intervention on pain catastrophizing, perceived pain, and pain tolerance in female university students. Participants will be assigned to one of three conditions: cognitive restructuring, acceptance, or a control. Pain tolerance and perception will be measured before and after each intervention using cold pressor tasks and questionnaires. The researchers hypothesize that high catastrophizers will report more pain and lower tolerance than low catastrophizers, and that the cognitive restructuring and acceptance interventions will reduce pain levels and increase tolerance over the control condition.

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This study aims to examine the efficacy of a cognitive restructuring intervention and an
acceptance intervention compared with a control condition to decrease pain
catastrophizing and thereby to reduce perceived pain intensity and improve pain tolerance
in a sample of female university students. Participants’ level of dispositional pain
catastrophizing will be pre-tested using the Pain Catastrophizing Scale (PCS; Sullivan,
Bishop & Pivik, 1995) and based on their scores on this measure, participants will be
divided into either high or low pain catastrophizers. Participants will then be randomly
assigned to one of three conditions, a cognitive restructuring condition, an acceptance
condition, or a control condition.
Participants in the cognitive restructuring condition will be provided with information
on how to identify and change stress-inducing thoughts and feelings that are associated
with pain. Participants in the acceptance condition will receive information on how to
disengage from their pain-related thoughts through acceptance. Finally, participants in the
control condition will be provided with neutral information, that is, information that will
not alter catastrophic thinking.
Pain tolerance during the Cold Pressor Task (CPT) will be measured as length of time
in seconds participants keep their hand immersed in the cold water. Pain perception will
be measured using the Short Form McGill questionnaire (Melzack, 1987) which assesses
both the sensory and affective aspects of perceived pain.
Introduction Measures
The Pain Catastrophizing Scale (PCS; Sullivan, Bishop & Pivik, 1995) assesses
participants, dispositional pain catastrophizing
The Acceptance and Action Questionnaire - II (AAQ-II; Bond et al., 2011) assesses
participants’ willingness to accept their undesirable thoughts and feelings.
The Coping Strategies Inventory (CSI; Tobin, Holroyd & Reynolds, 1984) assesses
participants’ habitual cognitive restructuring of stressful thoughts.
The Short Form McGill Pain Questionnaire (Melzack, 1987) assesses participants’ self-
reported sensory and affective perception of pain.
Pain tolerance will be measured using a stopwatch, as the length of time in seconds
participants leave their hand submerged in the cold-pressor apparatus.
Participants will be asked to write down three pain-related thoughts that emerged during
the first cold-pressor task in order to work on these thoughts using the specific coping
strategy to which they are assigned.
Cognitive Restructuring
In the cognitive restructuring condition, participants will
listen to instructions via headphones on how to re-appraise stress-
inducing thoughts in relation to pain, along with examples of rebuttals to their distressing
thoughts.
“You have substantial control over how you think about and interpret pain sensations.
Your unpleasant thoughts can be replaced by helpful and functional thoughts”.
If you have the worrying thoughts: Try to substitute with these thoughts:
Acceptance
In the acceptance condition, participants will listen to information via headphones on how
to disengage and accept their pain-related thoughts.
“It is often more beneficial to be willing to experience your unwanted feelings such as
pain or sadness, as opposed to trying to change or control them.”
“It is a good strategy to merely be aware of your thoughts, without judging them or
trying to change them. You may think of your thoughts as clouds in the sky.”.
References
(1) Participants who are high on dispositional pain catastrophizing will report increased
levels of pain, and have a lower pain tolerance compared to participants who are low
on pain catastrophizing.
(2) Participants who undergo the cognitive restructuring intervention or the acceptance
intervention will report lower levels of pain and have a higher tolerance for pain
compared to participants in the control condition
(3) There may be a possible interaction effect between level of dispositional pain
catastrophizing and type of coping strategy condition.
Researcher: Kady Francis
Supervisor: Ms. Anne Marie Keane
A Brief Cognitive Restructuring or Acceptance
Intervention to Decrease Catastrophizing and Reduce
Pain in a Sample of Female University Students
Design
Aims and Objectives
Interventions
Emotions
I don’t think I can take the pain anymore I can manage, I have overcome worse pain
The pain is too intense Just because I am in pain, does not mean I
am being harmed.
I am worried the pain will get worse I will only feel pain for a short period of
time.
Behaviours Thoughts
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., . . . Zettle, R. D. (2011). Preliminary psychometric properties of the
acceptance and action questionnaire – II: A revised measure of psychological inflexibility and experiential avoidance. Behaviour Therapy, 42, 676-688.
Melzack, R. (1987). The short form McGill Pain Questionnaire. Pain, 30. 191-197.
Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: development and validation. Psychological assessment, 7(4), 524.
Tobin, D. L., Holroyd, K. A., & Reynolds, R. V. C. (1984). Coping strategies inventory. Ohio: Department of Psychology, Ohio University,12
Pre-screening
online
Top 30%
Catastrophizers
Pre-test CPT
Cognitive
Restructuring
Acceptance
Post-test CPT
Control
Bottom 30%
Catastrophizers
Pre-test CPT
Cognitive
Restructuring
Acceptance
Post-test CPT
Control