Patients reported greater pain intensity, interference, downtime, and pain catastrophizing when the spouse was present than when the spouse was absent.

Within-person increases in pain catastrophizing were positively associated with spouse reports of patient pain behavior at the same time and 3 hours later.

Within-person increases in pain catastrophizing were positively associated with patient perceptions of spouse support, criticism, and hostility at the same time.

Within-person increases in pain catastrophizing were negatively associated with spouse reports of criticism and hostility 3 hours later.

Pain catastrophizing may affect the interpersonal environment of patients and spouses.