(283) Temporal associations among state pain catastrophizing, pain intensity, and pain tolerance in the cold pressor task: The effect of prior experience with cold thermal stimuli

BACKGROUND: Typical interventions for acute pain in children attempt to reduce pain by directing attention away from pain. Conversely, mindfulness involves devoting attention to one’s experience in an accepting and nonjudgmental way. However, the effect that instructing children to mindfully devote attention to acute pain has on pain outcomes is unknown.OBJECTIVES: To examine whether mindful attention can help children attend to pain without increasing pain intensity or decreasing pain tolerance; to compare the effects of mindful attention with a well-established intervention designed to take attention away from pain (guided imagery); and to test whether baseline coping style or trait mindfulness alter the effects of these interventions.METHODS: A total of 82 children (10 to 14 years of age) completed measures of coping style and trait mindfulness. Participants then received either mindful attention or guided imagery instructions designed to direct attention toward or away from pain, respectively, before participating in a cold pressor task.RESULTS: The mindful attention group reported more awareness of the physical sensations of pain and thoughts about those sensations. Overall, there were no between-group differences in measures of pain intensity or pain tolerance during the cold pressor task, and no evidence of an interaction between baseline characteristics of the child and experimental condition.CONCLUSIONS: Mindful attention was successful in helping children focus attention on experimental pain without increasing pain intensity or decreasing tolerance compared with a well-established intervention for acute pain reduction.

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The mechanisms of pain tolerance and pain-related anxiety in acute pain

Health Psychology Open ◽

10.1177/2055102919865161 ◽

2019 ◽

Vol 6 (2) ◽

pp. 205510291986516 ◽

Cited By ~ 2

Author(s):

Alina Cimpean ◽

Daniel David

Keyword(s):

Pain Catastrophizing ◽

Cold Pressor ◽

Pain Tolerance ◽

Path Model ◽

Cold Pressor Task ◽

Psychological Measures ◽

Before And After ◽

Healthy Sample ◽

Anxiety Response ◽

Response Expectancies

This study emphasizes the role of pain catastrophizing and state anxiety on pain tolerance and pain-related anxiety. Response expectancies for pain tolerance and pain intensity were tested as potential mediators. A cold-pressor task was used on a healthy sample. Measures were taken before and after cold-pressor procedure, while aversive versus neutral information regarding the cold-pressor task was given prior to the pain induction. An exploratory path model was conducted. Similar paths for pain tolerance and for pain-related anxiety were shown in aversive condition. Also, psychological measures may explain pain experience in aversive context.

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Electronic Gaming as Pain Distraction

Pain Research and Management ◽

10.1155/2011/856014 ◽

2011 ◽

Vol 16 (1) ◽

pp. 27-32 ◽

Cited By ~ 33

Author(s):

Eleanor Jameson ◽

Judy Trevena ◽

Nic Swain

Keyword(s):

Pain Intensity ◽

Pain Control ◽

Cold Pressor ◽

Pain Tolerance ◽

Experimental Procedure ◽

Cold Pressor Task ◽

Electronic Games ◽

Active Distraction ◽

Passive Distraction ◽

And Task

The current study investigated whether active distraction reduces participants’ experience of pain more than passive distraction during a cold pressor task. In the first experiment, 60 participants were asked to submerge their hand in cold (2°C) water for as long as they could tolerate. They did this with no distraction, and then with active (electronic gaming system) and passive (television) distraction, in randomly assigned order. Tolerance time, pain intensity ratings and task absorption ratings were measured for each condition. A second experiment attempted to control for participants’ expectations about the effects of distraction on pain. Forty participants underwent the same experimental procedure, but were given verbal suggestions about the effects of distraction by the experimenter before each distraction condition. Participants in both experiments had a significantly higher pain tolerance and reported less pain with the active distraction compared with passive or no distraction. Participants reported being more absorbed, and were significantly more willing to do the task again when they had the active distraction compared with both passive distraction and no distraction. They also had more enjoyment, less anxiety and greater reduction in pain with active distraction than with passive distraction. There was no effect of suggestion. These experiments offer further support for the use of electronic games as a method of pain control.

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The Confounding Effect of Assessor Ethnicity on Subjective Pain Reporting in Women

The Open Anesthesiology Journal ◽

10.2174/1874321801711010001 ◽

2017 ◽

Vol 11 (1) ◽

pp. 1-11

Author(s):

Jacob Miguel Vigil ◽

Patrick Coulombe ◽

Lauren Nikki Rowell ◽

Chance Strenth ◽

Eric Kruger ◽

...

Keyword(s):

Pain Intensity ◽

Severe Pain ◽

Pain Sensitivity ◽

Cold Pressor ◽

Pain Tolerance ◽

Random Effects Models ◽

Subjective Pain ◽

Lower Pain ◽

Pain Reporting ◽

Hispanic White

The current study examines how subjective pain reporting is influenced by the concordant and discordant nature of the ethnic identities of pain expressers (participants) and pain assessors (experimenters). Three discomfort conditions that varied in stimuli intensity (Study 1: mild pain; Study 2: severe pain), and distraction components (Study 3) were used to assess whether pain intensity and tolerance reporting differ with the ethnic identification of the participant and the experimenter. Specifically, 87 Hispanic and 74 Non-Hispanic White (NHW) women (18–51 yrs., Mage = 20.0, SD = 4.3) underwent a cold pressor pain task (CPT) after engaging in minimal procedural interactions with one of the 22 research experimenters (47% Hispanic, 42% females). The procedural interactions with the experimenters included only consenting and instructions, with no interaction between experimenter and participant during the actual CPT. Random-effects models showed that between the 0% and 18% of the variance in pain sensitivity (intensity and tolerance scores) was attributable to characteristics of the experimenters. Controlling for self-esteem, baseline pain levels, and the gender of the experimenter, Hispanic subjects showed higher pain sensitivity (as marked by lower pain tolerance and higher pain intensity scores) following interactions with an NHW rather than a Hispanic experimenter in response to the most severe pain intensity stimuli. These results question the validity of common findings of ethnic differences in pain sensitivity from studies that have not accounted for the ethnic identity of the pain assessor (and the general communicative nature of pain reporting).

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Taboo gesticulations as a response to pain

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0321 ◽

2019 ◽

Vol 19 (2) ◽

pp. 397-406

Author(s):

Maarten Jacobs ◽

Ilja van Beest ◽

Richard Stephens

Keyword(s):

Pain Perception ◽

Index Finger ◽

Cold Pressor ◽

Middle Finger ◽

Pain Tolerance ◽

Cold Pressor Task ◽

Main Effect ◽

Lower Pain ◽

Finger Control ◽

Ice Water

Abstract Background and aims Prior research indicates that swearing increases pain tolerance and decreases pain perception in a cold pressor task. In two experiments, we extend this research by testing whether taboo hand gesticulations have a similar effect. Methods Study 1 focused on males and females who, across two trials, submerged an extended middle finger (taboo) and an extended index finger (control) in ice water until discomfort necessitated removal. Study 2 focused exclusively on pain perception in males who, across three trials, submerged their hand, flat, with extended middle finger and with extended index finger, for 45 s each. Results In study 1 taboo gesticulation did not increase pain tolerance or reduce pain perception compared with the index finger control condition, as a main effect or as part of an interaction with condition order. While there was a gesture×gender interaction for pain tolerance, this was driven by an increased pain tolerance for the index finger gesture for women but not men. The results of study 2 again showed that taboo gesticulation did not lower pain perception, although it did increase positive affect compared with both non-taboo gesture conditions. Conclusions Taken together these results provide only limited evidence that taboo gesticulation alters the experience of pain. These largely null findings further our understanding of swearing as a response to pain, suggesting that the activation of taboo schemas is not sufficient for hypoalgesia to occur.

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Hope Against the Cold: Individual Differences in Trait Hope and Acute Pain Tolerance on the Cold Pressor Task

Journal of Personality ◽

10.1111/j.1467-6494.2005.00318.x ◽

2005 ◽

Vol 73 (2) ◽

pp. 287-312 ◽

Cited By ~ 61

Author(s):

C. R. Snyder ◽

Carla Berg ◽

Julia T. Woodward ◽

Amber Gum ◽

Kevin L. Rand ◽

...

Keyword(s):

Individual Differences ◽

Acute Pain ◽

Cold Pressor ◽

Pain Tolerance ◽

Cold Pressor Task ◽

Trait Hope

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The effects of auditory background noise and virtual reality technology on video game distraction analgesia

Scandinavian Journal of Pain ◽

10.1515/sjpain-2018-0123 ◽

2019 ◽

Vol 19 (1) ◽

pp. 207-217 ◽

Cited By ~ 2

Author(s):

Julia A. Zeroth ◽

Lynnda M. Dahlquist ◽

Emily C. Foxen-Craft

Keyword(s):

Virtual Reality ◽

Pain Intensity ◽

Video Game ◽

Background Noise ◽

Cold Pressor ◽

Pain Tolerance ◽

Relative Efficacy ◽

Noise Condition ◽

Head Mounted Display ◽

The Impact

Abstract Background and aims The present study was designed to evaluate the relative efficacy of two video game display modalities – virtual reality (VR) assisted video game distraction, in which the game is presented via a VR head-mounted display (HMD) helmet, versus standard video game distraction, in which the game is projected on a television – and to determine whether environmental context (quiet versus noisy) moderates the relative efficacy of the two display modalities in reducing cold pressor pain in healthy college students. Methods Undergraduate students (n=164) were stratified by sex and self-reported video game skill and were randomly assigned to a quiet or a noisy environment. Participants then underwent three cold pressor trials consisting of one baseline followed by two distraction trials differing in display modality (i.e. VR-assisted or standard distraction) in counter-balanced order. Results Participants experienced improvement in pain tolerance from baseline to distraction in both display modality conditions (p<0.001, partial η2=0.41), and there was a trend toward greater improvement in pain tolerance from baseline to distraction when using the VR HMD helmet than during standard video game distraction (p=0.057, partial η2=0.02). Participants rated pain as more intense when experienced with concurrent experimental background noise (p=0.047, partial η2=0.02). Pain tolerance was not influenced by the presence or absence of background noise, and there was not a significant interaction between display modality and noise condition. Though exploratory sex analyses demonstrated a significant three-way interaction between noise condition, sex, and display modality on pain intensity (p=0.040, partial η2=0.040), follow-up post-hoc analyses conducted for males and females separately did not reveal significant differences in pain intensity based on the interaction between noise condition and display modality. Conclusions As expected, video game distraction both with and without an HMD helmet increased pain tolerance; however, the two display modalities only marginally differed in efficacy within the population under study. The effect of auditory background noise on pain was mixed; while pain tolerance did not vary as a function of the presence or absence of background noise, the addition of noise increased pain intensity ratings. The interaction between participant sex, noise condition, and distraction modality on pain intensity trended toward significance but would require replication in future research. Implications Results suggest that video game distraction via HMD helmet may be superior to standard video game distraction for increasing pain tolerance, though further research is required to replicate the trending findings observed in this study. Though it does not appear that background noise significantly impacted the relative efficacy of the two different video game display modalities, the presence of noise does appear to alter the pain response through amplified pain intensity ratings. Further research utilizing more sophisticated VR technology and clinically relevant background auditory stimuli is necessary in order to better understand the impact of these findings in real-world settings and to test the clinical utility of VR technology for pain management relative to standard video game distraction.

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Improving Exposure Component and Generalization Potential of Stress Inoculation for Pain

Perceptual and Motor Skills ◽

10.2466/pms.1979.48.3c.1132 ◽

1979 ◽

Vol 48 (3_suppl) ◽

pp. 1132-1134 ◽

Cited By ~ 8

Author(s):

Gail Hackett ◽

John J. Horan ◽

Jay Buchanan ◽

Paul Zumoff

Keyword(s):

Coping Skills ◽

Cold Pressor ◽

Pain Tolerance ◽

The Other ◽

Stress Inoculation ◽

Practice Session ◽

Cold Pressor Task ◽

Pressure Algometer ◽

Dimensions Of Pain ◽

Psychological Dimensions

Stress inoculation for pain involves education about the psychological dimensions of pain, training in a number of coping skills, and practice in applying these skills during exposure to the noxious stimulus. In a previous study the exposure component (which involved six practice sessions) proved ineffective; moreover the efficacy of the other components was not repeated on the generalization measures. The present study compared three variations in the exposure component and found that training with a single practice session on the cold pressor task proved more helpful than training with no practice at all, which in turn was no worse than training with six practice sessions. Moreover, therapeutic attention to generalization resulted in increased pain tolerance on the pressure algometer task.

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A longitudinal exploration of pain tolerance and participation in contact sports

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.02.007 ◽

2017 ◽

Vol 16 (1) ◽

pp. 36-44 ◽

Cited By ~ 11

Author(s):

Claire Thornton ◽

David Sheffield ◽

Andrew Baird

Keyword(s):

Pain Intensity ◽

Experimental Pain ◽

Cold Pressor ◽

Pain Tolerance ◽

Drop Out ◽

American Football ◽

Pain Coping ◽

Cold Pain ◽

Contact Sports ◽

Over Time

AbstractBackground/aims Athletes who choose to engage in contact sports do so with the knowledge that participation will bring pain in the form of contact with others, injury, and from exertion. Whilst athletes who play contact sports have been shown to have higher pain tolerance than those who do not, it is unclear whether this is a result of habituation over time, or as a result of individual differences at the outset. The aim was to compare pain responses over an athletic season in athletes who participated in contact sport and those who disengaged from it.Methods One hundred and two new contact athletes completed measures of cold and ischaemic pain tolerance, perceived pain intensity, pain bothersomeness, pain coping styles and attendance at the start, middle (4 months) and end (8 months) of their season. The athletes were drawn from martial arts, rugby and American football. Cluster analysis placed 47 athletes into a participating category and 55 into a non-participating cluster.ResultsParticipating athletes had higher ischaemic pain tolerance at the start (r = 0.27, p = 0.05), middle (r = 0.41, p < 0.0001) and end of the season (r = 0.57, p < 0.0001) compared to non-participating athletes. In addition participating athletes were more tolerant to cold pain at the end of the season (r = 0.39, p < 0.0001), compared to non-participating athletes. Participating athletes also exhibited higher direct coping, catastrophized less about injury pain and also found contact pain to be less bothersome physically and psychologically compared to non-participating athletes. Participating athletes were more tolerant of ischaemic pain at the end of the season compared to the start (r = 0.28, p = 0.04). Conversely nonparticipating athletes became significantly less tolerant to both pain stimuli by the end of the season (cold pressor; r = 0.54, p < 0.0001; ischaemia; r = 0.43, p = 0.006). Pain intensity as measured by a visual analogue scale did not change over the season for both groups.Conclusions Those who cease participation in contact sports become less pain tolerant of experimental pain, possibly a result of catastrophizing. The results suggest that athletes who commit to contact sports find pain less bothersome over time, possibly as a result of experience and learning to cope with pain. Athletes who continue to participate in contact sports have a higher pain tolerance, report less bothersomeness and have higher direct coping than those who drop out. In addition, tolerance to ischaemic pain increased over the season for participating athletes.ImplicationsHaving a low pain tolerance should not prevent athletes from taking part in contact sports, as pain becomes less bothersome in athletes who adhere to such activities. Participating in contact sports may result in maintained cold pain tolerance, increased ischaemic pain tolerance, reduced catastrophizing and better coping skills. Coaches can therefore work with athletes to develop pain coping strategies to aid adherence to contact sports.

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