Exploring metacognitions in health anxiety and chronic pain: a cross-sectional survey

Abstract Background The occurrence of health anxiety (HA) in chronic pain is associated with adverse outcomes. As such, it is important to identify constructs that might influence HA and pain-related outcomes. Metacognitions are an emerging area of interest in both HA and chronic pain, but the relationship between the three factors has not been extensively examined. The current study sought to examine the role of metacognitions about health in HA and pain-related outcomes in chronic pain. Methods This study utilized a cross-sectional design. Undergraduate students with self-reported chronic pain (n = 179) completed online measures of HA, pain intensity, pain disability, and metacognitions about health. Results Regression analyses indicated that both metacognitions about biased thinking and that thoughts are uncontrollable predicted HA in chronic pain, while only metacognitions about biased thinking predicted pain-related disability beyond pain intensity. Conclusion Results demonstrate that HA and pain-related disability are not associated when taking metacognitions about health into account, suggesting that metacognitions about health at least partially account for the relationship between the two. Further, results suggest that metacognitions about biased thinking may independently influence HA and pain-related disability within chronic pain.