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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

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Volume 11, Issue 1


Social Anxiety, Pain Catastrophizing and Return-To-Work Self-Efficacy in chronic pain: a cross-sectional study

Johanna Thomtén / Katja Boersma
  • Center for Health and Medical Psychology, JPS: Psychology, Örebro University, Örebro Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ida Flink
  • Center for Health and Medical Psychology, JPS: Psychology, Örebro University, Örebro Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Maria Tillfors
  • Center for Health and Medical Psychology, JPS: Psychology, Örebro University, Örebro Sweden
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-04-01 | DOI: https://doi.org/10.1016/j.sjpain.2015.10.005


Background and aims

Returning to work after periods of sick-leave due to chronic pain problems, involve a number of situations of interpersonal nature (e.g. meeting supervisors/insurance companies to adapt work setting to present functional level, receive help from colleagues, express pain, etc.). Since chronic pain has shown co-morbidity with social anxiety, it is of interest to investigate restraining factors in return to work among chronic pain sufferers from a social perspective. Catastrophizing is identified in both pain and social anxiety as a mechanism that might fuel a continuous bias in how situations are perceived (threat) and by hindering the development of functional behavior strategies. The presence of social anxiety in chronic pain patients might be seen as a stressor that limits the individuals’ ability to effectively communicate pain-related needs to colleagues, and/or employers and therefore act as a hindering factor in return-to-work. Hence, the overall aim of this study was to examine the relationship between social anxiety, pain catastrophizing, and perceived ability to communicate pain-related needs to the work environment in a clinical pain population.


The study employed a cross-sectional design and involved 247 individuals with chronic pain (82.3% women; Mage = 44 years). Measures included the Pain catastrophizing Scale, the Social Phobia Screening Questionnaire and the communication of pain-related needs-subscale of the Return-To-Work Self-efficacy Questionnaire. Analyzes were run to examine whether social anxiety moderated the relation between pain catastrophizing, and perceived ability to communicate pain-related needs while controlling for pain severity/interference and sick leave.


Social anxiety and pain catastrophizing correlated positively with each other and negatively with perceived ability to communicate pain-related needs. No support was obtained for a moderating effect of social anxiety. However, social anxiety and pain interference were each significant predictors of the individual’s confidence in being able to communicate pain-related needs to the work environment.


In the context of pain and work-related communication, symptoms of social anxiety was identified as being of similar importance to the outcome as pain interference, while pain severity was not associated with the individual’s confidence in communicating one’s pain-related needs.


The results implicate that fears relating to pain-related social situations at work might be central in the process of return-to-work and rehabilitation in chronic pain.

Keywords: Clinical pain population; Social anxiety; Pain catastrophizing; Return to work; Communicating pain-related needs; Co-morbidity


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About the article

Department of Psychology, Mid Sweden University, Kunskapens vag 1,831 25 Östersund, Sweden

Received: 2015-08-12

Revised: 2015-10-12

Accepted: 2015-10-13

Published Online: 2016-04-01

Published in Print: 2016-04-01

Conflict of interest: The authors declare that they have no conflict of interest.

Citation Information: Scandinavian Journal of Pain, Volume 11, Issue 1, Pages 98–103, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2015.10.005.

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