scholarly journals Dispositional and situational personal features and acute post-collision head and neck pain: Double mediation of pain catastrophizing and pain sensitivity

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262076
Author(s):  
Michal Granot ◽  
Einav Srulovici ◽  
Yelena Granovsky ◽  
David Yarnitsky ◽  
Pora Kuperman

Pain variability can be partially attributed to psycho-cognitive features involved in its processing. However, accumulating research suggests that simple linear correlation between situational and dispositional factors may not be sufficiently explanatory, with some positing a role for mediating influences. In addition, acute pain processing studies generally focus on a post-operative model with less attention provided to post-traumatic injury. As such, this study aimed to investigate a more comprehensive pain processing model that included direct and indirect associations between acute pain intensity in the head and neck, pain catastrophizing (using pain catastrophizing scale (PCS)), and pain sensitivity (using the pain sensitivity questionnaire (PSQ)), among 239 patients with post-motor vehicle collision pain. The effect of personality traits (using Ten Items Personality Inventory (TIPI)) and emotional status (using Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS)) on that model was examined as well. To this end, three Structural Equation Modeling (SEM) analyses were conducted. Overall, the data had good fit to all the models, with only PSQ found to have a direct correlation with acute pain intensity. The SEM analyses conversely revealed several mediations. Specifically, that: first, PSQ fully mediated the relationship between PCS and pain intensity; second, PCS and PSQ together fully mediated the relationship between conscientiousness (personality trait) and pain intensity; and finally, emotional status had direct and indirect links with PSQ and pain intensity. In conclusion, these models suggest that during the acute post-collision phase, pain sensitivity intermediates between emotional states and personality traits, partially via elevated pain catastrophizing thoughts.

2010 ◽  
Vol 15 (4) ◽  
pp. 229-237 ◽  
Author(s):  
Claudia Huber ◽  
Miriam Kunz ◽  
Cordula Artelt ◽  
Stefan Lautenbacher

BACKGROUND/OBJECTIVE: It is known that maladaptive attentional and emotional mechanisms of pain processing – as indicated by constructs such as pain hypervigilance, pain-related anxiety and pain catastrophizing – play an important role in the development and maintenance of chronic pain conditions. However, little is known to date about the potential risk factors for these forms of maladaptive processing. The aim of the present study was to shed more light on this issue. A very comprehensive set of predictor variables was examined in healthy pain-free subjects.METHOD: Participants were 92 young and healthy subjects (mean [± SD] age 26.99±6.90 years; 47 men, 45 women). Maladaptive attentional and emotional mechanisms of pain processing were assessed by self-report measures of pain hypervigilance, pain-related anxiety and pain catastrophizing, as well as by a dot-probe task. The comprehensive set of predictor variables included measures of affective and bodily distress (depression, anxiety and somatization), experimental pain sensitivity, and cortisol reactivity. Directed relationships were estimated by using structural equation modelling.RESULTS: Structural equation modelling revealed a significant path from affective and bodily distress to self-reported maladaptive attentional and emotional pain processing. In contrast, the paths from pain sensitivity and cortisol reactivity did not reach the level of significance.CONCLUSION: These results support the position that anxiety and depression, as well as somatization, contribute to the aberrance of attentional and emotional mechanisms of pain processing. Surprisingly, the assumption of a close relationship between these maladaptive mechanisms of pain processing and pain sensitivity could not be confirmed.


2017 ◽  
Vol 127 (1) ◽  
pp. 136-146 ◽  
Author(s):  
Yasamin Sharifzadeh ◽  
Ming-Chih Kao ◽  
John A. Sturgeon ◽  
Thomas J. Rico ◽  
Sean Mackey ◽  
...  

Abstract Background Pain catastrophizing is a maladaptive response to pain that amplifies chronic pain intensity and distress. Few studies have examined how pain catastrophizing relates to opioid prescription in outpatients with chronic pain. Methods The authors conducted a retrospective observational study of the relationships between opioid prescription, pain intensity, and pain catastrophizing in 1,794 adults (1,129 women; 63%) presenting for new evaluation at a large tertiary care pain treatment center. Data were sourced primarily from an open-source, learning health system and pain registry and secondarily from manual review of electronic medical records. A binary opioid prescription variable (yes/no) constituted the dependent variable; independent variables were age, sex, pain intensity, pain catastrophizing, depression, and anxiety. Results Most patients were prescribed at least one opioid medication (57%; n = 1,020). A significant interaction and main effects of pain intensity and pain catastrophizing on opioid prescription were noted (P < 0.04). Additive modeling revealed sex differences in the relationship between pain catastrophizing, pain intensity, and opioid prescription, such that opioid prescription became more common at lower levels of pain catastrophizing for women than for men. Conclusions Results supported the conclusion that pain catastrophizing and sex moderate the relationship between pain intensity and opioid prescription. Although men and women patients had similar Pain Catastrophizing Scale scores, historically “subthreshold” levels of pain catastrophizing were significantly associated with opioid prescription only for women patients. These findings suggest that pain intensity and catastrophizing contribute to different patterns of opioid prescription for men and women patients, highlighting a potential need for examination and intervention in future studies.


2019 ◽  
Vol 8 (8) ◽  
pp. 1246 ◽  
Author(s):  
Fernando Piña-Pozo ◽  
Alberto Marcos Heredia-Rizo ◽  
Pascal Madeleine ◽  
Isabel Escobio-Prieto ◽  
Antonio Luque-Carrasco ◽  
...  

Current evidence for widespread hyperalgesia in non-specific neck pain (NSNP) is unclear. It is currently recommended to group NSNP patients according to pain-provoking movements. The aim of this study was to investigate local and widespread pain sensitivity in females with unilateral NSNP that is reproducible during passive neck rotation compared with matched controls, and to compare the side specific effect of pain location on pressure pain sensitivity among females with unilateral NSNP. Thirty-six females with unilateral NSNP evoked during passive ipsilateral (n = 20) or contralateral (n = 16) rotation toward the painful side were compared with 20 controls. Participants reported their pain intensity at rest and during passive neck rotation and completed the Neck Disability Index. Pressure pain thresholds (PPTs) were assessed bilaterally over the anterior scalene; the sternocleidomastoid; the levator scapulae; lateral to the spinous process of C6; the median, ulnar, and radial nerves; and the tibialis anterior. The ANOVA revealed lower PPTs in females with unilateral NSNP compared with the controls (all at p < 0.001), but no differences were found between the sides, nor was there any Group × side interaction. Among females with NSNP, those with higher pain intensity during ipsilateral rotation toward the painful side showed lower PPTs over the anterior scalene, median nerve, ulnar nerve, and tibialis anterior (all, p < 0.05) than females with higher pain intensity during contralateral rotation toward the painful side. These findings demonstrated bilateral local and widespread pressure pain hyperalgesia in females with unilateral NSNP that was reproducible during passive neck rotation compared with controls. There was no side specific effect of pain location on PPTs among females with unilateral NSNP.


2020 ◽  
Vol 9 (11) ◽  
pp. 3564
Author(s):  
Luis Ceballos-Laita ◽  
María Teresa Mingo-Gómez ◽  
Francisco Navas-Cámara ◽  
Elena Estébanez-de-Miguel ◽  
Santos Caudevilla-Polo ◽  
...  

Background: We compared the effects of therapeutic exercise (TE) combined with pain neurophysiology education (PNE) to those of TE in isolation on pain intensity, general fibromyalgia impact, mechanical pain sensitivity, pain catastrophizing, psychological distress and quality of life in women with fibromyalgia syndrome (FMS). Methods: A feasibility study with a 3 month follow-up was designed. Thirty-two patients with FMS were randomly assigned to PNE + TE group (n = 16) or to TE group (n = 16). Both groups received 30 sessions of TE (3 per week), and the PNE + TE group received eight face-to-face educational sessions. The measuring instruments used were the visual analogue scale, a standard pressure algometer, the Revised Fibromyalgia Impact Questionnaire, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale and the Health Assessment Questionnaire. Results: The PNE + TE group showed a statistically significant decrease on pain intensity compared to TE group at short term (p = 0.015). No between-groups differences were found for mechanical pain sensitivity, general fibromyalgia impact, pain catastrophizing, psychological distress or quality of life (p > 0.05). Conclusions: The combination of PNE and TE was more effective than TE for reducing pain intensity in the short-term. No differences were found for psychological distress, pain catastrophizing and quality of life after the intervention or at 3 months of follow-up.


2017 ◽  
Vol 17 (1) ◽  
pp. 390-396 ◽  
Author(s):  
John A. Sturgeon ◽  
Maisa S. Ziadni ◽  
Zina Trost ◽  
Beth D. Darnall ◽  
Sean C. Mackey

AbstractBackground and purposePrevious research has highlighted the importance of cognitive appraisal processes in determining the nature and effectiveness of coping with chronic pain. Two of the key variables implicated in appraisal of pain are catastrophizing and perceived injustice, which exacerbate the severity of pain-related distress and increase the risk of long-term disability through maladaptive behavioural responses. However, to date, the influences of these phenomena have not been examined concurrently, nor have they been related specifically to quality of life measures, such as life satisfaction.MethodsUsing data froman online survey of330 individuals with chronic pain, structural path modelling techniques were used to examine the independent effects of pain catastrophizing, perceived injustice, and average pain intensity on life satisfaction. Two potential mediators of these relationships were examined: depressive symptoms and pain-related interference.ResultsResults indicated that depressive symptoms fully mediated the relationship between pain catastrophizing and life satisfaction, and pain interference fully mediated the relationship between pain intensity and life satisfaction. Both depressive symptoms and pain interference were found to significantly mediate the relationship between perceived injustice and life satisfaction, but perceived injustice continued to demonstrate a significant and negative relationship with life satisfaction, above and beyond the other study variables.ConclusionsThe current findings highlight the distinct affective and behavioural mediators of pain and maladaptive cognitive appraisal processes in chronic pain, and highlight their importance in both perceptions of pain-related interference and longer-term quality of life.


2009 ◽  
Vol 14 (4) ◽  
pp. 299-305 ◽  
Author(s):  
Joel Katz ◽  
Andrea L Martin ◽  
M Gabrielle Pagé ◽  
Vincent Calleri

BACKGROUND: Alexithymia is a disturbance in awareness and cognitive processing of affect that is associated with over-reporting of physical symptoms, including pain. The relationship between alexithymia and other psychological constructs that are often associated with pain has yet to be evaluated.OBJECTIVES: The present study examined the importance of alexithymia in the pain experience in relation to other integral psychological components of Turk’s diathesis-stress model of chronic pain and disability, including fear of pain, anxiety sensitivity, pain avoidance and pain catastrophizing.METHODS: Heat pain stimuli, using a magnitude estimation procedure, and five questionnaires (Anxiety Sensitivity Index, Fear of Pain Questionnaire III, Pain Catastrophizing Scale, avoidance subscale of the Pain Anxiety Symptoms Scale-20 and Toronto Alexithymia Scale-20) were administered to 67 undergraduate students (44 women) with a mean (± SD) age of 20.39±3.77 years.RESULTS: Multiple linear regression analysis revealed that sex, fear of pain and alexithymia were the only significant predictors of average heat pain intensity (F[6, 60]=5.43; R2=0.35; P=0.008), accounting for 6.8%, 20.0% and 9.6% of unique variance, respectively. Moreover, the difficulty identifying feelings and difficulty describing feelings subscales, but not the externally oriented thinking subscale of the Toronto Alexithymia Scale-20 significantly predicted average heat pain intensity.CONCLUSIONS: Individuals with higher levels of alexithymia or increased fear of pain reported higher average pain intensity ratings. The relationship between alexithymia and pain intensity was unrelated to other psychological constructs usually associated with pain. These findings suggest that difficulties with emotion regulation, either through reduced emotional awareness via alexithymia or heightened emotional awareness via fear of pain, may negatively impact the pain experience.


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