Cambridge Prisms: Global Mental Health · Published 2026-01-01 · DOI 10.1017/gmh.2026.10151
Abstract Background Chronic pain represents a major global public health issue. It is associated with wide-ranging psychosocial consequences. Extensive evidence has demonstrated that pain catastrophizing (PC) contributes to the bidirectional association between chronic pain and psychological distress. The present study aims to explore the psychological and cognitive correlates of chronic pain among individuals living in Gaza. Methods A cross-sectional study was conducted among 272 adults with chronic musculoskeletal pain. Spearman’s correlations assessed associations between pain intensity, catastrophizing and depressive symptoms. Multiple regression and bootstrapped mediation analyses (5,000 resamples and PROCESS macro) evaluated predictors and the mediating role of catastrophizing in the pain–depression relationship. Results Pain intensity was positively correlated with depression (r = 0.28, p < 0.001) and catastrophizing (r = 0.39, p < 0.001). A stronger correlation was found between catastrophizing and depression (r = 0.54, p < 0.001). Mediation analysis demonstrated that catastrophizing fully mediated the association between pain intensity and depression (indirect effect = 0.95, 95% confidence interval = [0.65–1.29]). Conclusion PC is a key psychological mechanism linking pain intensity and depression among patients with chronic pain in Gaza. Integrating cognitive-behavioral therapy, mindfulness and emotion regulation strategies into pain management may improve mental health outcomes in conflict-affected settings.
Abstract from DOAJ. Public domain (CC0 1.0).
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