Theory 039/Mind & Behaviour /Clinical psychology
Catastrophising Is a Precision Failure
Catastrophising is treated as a cognitive distortion. It may be a weighting problem in the other direction.
Pain catastrophising reflects a failure to weight sensory evidence rather than an exaggerated belief, so it should be reduced by increasing the precision of bodily signals rather than by changing what the patient thinks.
01The evidence
Catastrophising predicts pain intensity and disability independently of nociceptive input, and it responds to treatments that target attention as well as to cognitive restructuring.
02The tension
Cognitive models treat catastrophising as a belief to be corrected. That predicts responses to belief-focused therapy, which are modest and variable.
03The mechanism
Perception weights prior expectation against sensory evidence. If the evidence is treated as unreliable, the prior dominates and the percept is driven by expectation, which is what catastrophising looks like from the inside.
That makes the problem a precision failure, and predicts that interventions which make bodily signals more discriminable should reduce catastrophising without addressing beliefs.
04What this is not
Those models target content. This targets the weighting, which predicts benefit from discrimination training.
05Predictions
- P1Catastrophising should correlate with sensory precision deficits.
- P2Discrimination training should reduce it.
- P3Belief change without precision change should have less effect.
06Refutation
Catastrophising responding only to belief change would favour the cognitive model.
07What it changes
It would add sensory training to pain treatment.