Exploring the Role of Pain Catastrophizing in Anxiety and Depression Among Breast Cancer Survivors Publisher



Akbarzade R ; Mohammadi A ; Bakhtiari Dovvombaygi H ; Ehsani M
Source: Journal of Education and Health Promotion Published:2026

Abstract

BACKGROUND: Breast cancer is the most frequently diagnosed cancer in women worldwide. Breast cancer survivors (BCSs) often face chronic adverse effects besides pain and pain catastrophizing (PC), including anxiety and depression. To understand how cognitive processes influence mental health outcomes in this population, it is important to investigate the relationship between PC and symptoms of anxiety and depression. This study aimed to explore the relationship between PC with anxiety and depression in BCS. MATERIALS AND METHODS: A total of 205 Iranian women with breast cancer participated (Mean = 43.55, SD = 4.92). They were gathered from two hospitals using a continuous sampling technique. The data were obtained by using four questionnaires, including a sociodemographic and disease information questionnaire, pain catastrophizing scale (PCS), Hamilton Anxiety Inventory (HAI), and Beck Depression Inventory-Short Form (BDI-s). RESULTS: Most participants (76.1%) reported low levels of PC, while 39.0% and 22.9% had high levels of depression and anxiety, respectively. Strong positive correlations were observed between these variables. PC was significantly correlated with depression (r = 0.80, P < 0.001) and anxiety (r = 0.77, P < 0.001). Similarly, depression was strongly associated with anxiety (r = 0.84, P < 0.001). CONCLUSION: This study confirms evidence that when there is more severe PC, greater levels of anxiety and depression are observed due to the presence of pain, cancer diagnosis, and treatment. © 2026 Journal of Education and Health Promotion.