The article provides a comprehensive review of pain catastrophizing, a negative cognitive-affective response to anticipated or actual pain, and its impact on various pain-related outcomes. The authors first discuss the conceptualization of pain catastrophizing, highlighting its historical context and unresolved issues. They then explore theoretical mechanisms such as appraisal theory, attention bias/information processing, communal coping, CNS pain processing mechanisms, psychophysiological pathways, and neural pathways. The review emphasizes the importance of pain catastrophizing in pain treatment, suggesting that it represents a critical process factor. The authors propose an integrated heuristic model for future research, focusing on the interdependence of various theoretical constructs. They also address measurement issues, the distinction between trait and state pain catastrophizing, and the construct redundancy with other negative affect constructs. The article concludes by discussing the association of pain catastrophizing with pain-related outcomes, including pain sensitivity, disability, and interpersonal relationships, and the potential mechanisms through which it influences these outcomes. Finally, the authors outline key areas for future research, emphasizing the need for more comprehensive assessments, the consideration of multiple processes, and the application of methodologies from other literatures to enhance understanding and treatment of pain catastrophizing.The article provides a comprehensive review of pain catastrophizing, a negative cognitive-affective response to anticipated or actual pain, and its impact on various pain-related outcomes. The authors first discuss the conceptualization of pain catastrophizing, highlighting its historical context and unresolved issues. They then explore theoretical mechanisms such as appraisal theory, attention bias/information processing, communal coping, CNS pain processing mechanisms, psychophysiological pathways, and neural pathways. The review emphasizes the importance of pain catastrophizing in pain treatment, suggesting that it represents a critical process factor. The authors propose an integrated heuristic model for future research, focusing on the interdependence of various theoretical constructs. They also address measurement issues, the distinction between trait and state pain catastrophizing, and the construct redundancy with other negative affect constructs. The article concludes by discussing the association of pain catastrophizing with pain-related outcomes, including pain sensitivity, disability, and interpersonal relationships, and the potential mechanisms through which it influences these outcomes. Finally, the authors outline key areas for future research, emphasizing the need for more comprehensive assessments, the consideration of multiple processes, and the application of methodologies from other literatures to enhance understanding and treatment of pain catastrophizing.