Catastrophic thinking about pain has been identified as an important determinant of adjustment to pain, in both adults and children. No study has investigated the prospective and unique role of catastrophizing in explaining later pain and disability in children. The aim of the present study was to investigate the prospective roles of catastrophic thinking about pain, pain intensity, and trait anxiety and their putative relationship with pain and disability tested 6 months later. Participants were 323 schoolchildren. Analyses revealed that the child's pain catastrophizing at baseline had a small but unique contribution to the prediction of pain and disability 6 months later, even when controlling for the initial pain and disability levels. In line with expectations, moderation analyses revealed that the effects of catastrophizing upon pain and disability at follow-up were only true for those children reporting low levels intensity of pain at baseline. The variability in disability and pain complaint could not be explained by trait anxiety. instead anxious disposition might be best conceived of as a precursor of catastrophizing in children; i.e. children with higher levels of trait anxiety at baseline were more inclined to report higher levels of catastrophizing at follow-up. The findings are discussed in terms of potential mechanisms through which catastrophizing might exert its negative impact upon pain and disability outcomes in children. (C) 2009 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.