Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Kamila S. White, PhD


Barbara Bucur

Zoe Peterson

Ann Steffen


Patients who present in medical settings with persistent chest pain in the absence of identifiable cardiac cause (Fleet & Beitman, 1997) may be diagnosed with non-cardiac chest pain (NCCP). NCCP is a common, costly condition that may result in impaired quality of life (e.g., Eslick et al. 2003; Wong et al., 2002). Theories of NCCP (Mayou, 1998; White & Raffa, 2004) suggest that patients who react to NCCP with fear and thoughts of catastrophic consequences may avoid activities that elicit cardiac sensations. The daily behavioral impact of avoiding cardiorespiratory cues may limit quality of life due to activity avoidance. The current study aimed to examine the psychological mechanisms, fear of pain and pain catastrophizing, in patients with NCCP to investigate whether these factors relate to lower quality of life even after controlling for psychiatric disorder severity. Patients with NCCP were recruited from cardiology clinics (N = 29). Findings indicate both fear of pain and pain catastrophizing relate to quality of life. This is one of the first studies to investigate the impact of pain catastrophizing and fear of pain on quality of life in patients with NCCP. It is unclear, however, due to underpowered analyses, whether fear of pain and catastrophizing explain a significant amount of variance in quality of life, after accounting for psychiatric disorder severity. In sum, this research adds understanding to contributory factors to impairment in quality of life of patients with NCCP.

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