scholarly journals Relationships between Psychological Factors and Experimental Pain Outcomes in Healthy Individuals: Results from 8 Studies

2021 ◽  
Author(s):  
Hadas Nahman-Averbuch ◽  
Ian A. Boggero ◽  
Benjamin M. Hunter ◽  
Hannah Pickerill ◽  
James L. Peugh ◽  
...  
Keyword(s):  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Experimental Pain ◽  
Healthy Individuals ◽  
Cold Pain ◽  
Total N ◽  
Pain Outcomes ◽  
Negative Findings ◽  
The Individual ◽  
Anxiety Depression

Psychological factors, such as anxiety, depression, and pain catastrophizing, may affect how healthy individuals experience experimental pain. However, current literature puts forth contradictory results, possibly due to differing study methodologies, such as the type of psychophysical measure or survey. To better understand such results, this paper analyzed the relationships between psychological factors and experimental pain outcomes across eight different studies (total n= 595) conducted in different populations of healthy adult and adolescent participants. Analyses were conducted with and without controlling for sex, age, and race. Each study was analyzed separately and as part of an aggregate analysis. Even without correction for multiple comparisons, only a few significant relationships were found for the individual studies. Controlling for demographic factors had minimal effect on the results. Importantly, even the few statistically significant models showed relatively small effect sizes; psychological factors explained no more than 20% of the variability in experimental pain sensitivity of healthy individuals. The aggregate analyses revealed relationships between anxiety and PPT / cold pain ratings and between pain catastrophizing and PPT. Sample size calculations based on the aggregate analyses indicated that several hundred participants would be required to correctly detect relationships between these psychological factors and pain measures. These overall negative findings suggest that anxiety, depression, and pain catastrophizing in healthy individuals may not be meaningfully related to experimental pain outcomes. Furthermore, positive findings in the literature may be subject to small group effects and publication bias towards positive findings.

scholarly journals Heritability of pain catastrophizing and associations with experimental pain outcomes

Pain ◽  
2015 ◽  
Vol 156 (3) ◽  
pp. 514-520 ◽  
Author(s):  
Zina Trost ◽  
Eric Strachan ◽  
Michael Sullivan ◽  
Tine Vervoort ◽  
Ally R. Avery ◽  
...  
Keyword(s):  
Pain Catastrophizing ◽  
Experimental Pain ◽  
Pain Outcomes

scholarly journals The Added Value of Sensitivity to Nonnoxious Stimuli to Predict an Individual’s Sensitivity to Pain

2021 ◽  
Vol 24 (6) ◽  
pp. E783-E794
Keyword(s):  
Postoperative Pain ◽  
Healthy Volunteers ◽  
Pain Score ◽  
Pain Sensitivity ◽  
Pain Catastrophizing ◽  
Light Sensitivity ◽  
Heat Pain ◽  
Cold Pain ◽  
Eye Color ◽  
Anxiety Depression

BACKGROUND: Simple tools are needed to predict postoperative pain. Questionnaire-based tools such as the Pain Sensitivity Questionnaire (PSQ) are validated for this purpose, but prediction could be improved by incorporating other parameters. OBJECTIVES: To explore the potency of sensitivity to nonpainful stimuli and biometric data to improve prediction of pain. STUDY DESIGN: Transversal exploratory study. SETTING: Single clinical investigation center. METHODS. Eighty-five healthy volunteers of both genders underwent a multimodal exploration including biometry, questionnaire-based assessment of anxiety, depression, pain catastrophizing, sensitivity to smell, and the PSQ, followed by a psychophysical assessment of unpleasantness thresholds for light and sound, and sensitivity to mechanical, heat, and cold pain. These last 3 parameters were used to calculate a composite pain score. After a multi-step selection, multivariable analyses identified the explanative factors of experimental pain sensitivity, by including biometric, questionnaire-based, and psychophysical nonnociceptive sensitivity parameters, with the aim of having each domain represented. RESULTS: Female gender predicted mechanical pain, a younger age and dark eyes predicted cold pain, and the PSQ predicted heat pain. Sensitivity to unpleasantness of sound predicted mechanical and heat pain, and sensitivity to unpleasantness of light predicted cold pain. Sensitivity to smell was unrelated. The predictors of the composite pain score were the PSQ, the light unpleasantness threshold, and an interaction between gender and eye color, the score being lower in light-eyed men and higher in all women. The final multivariable multi-domain model was more predictive of pain than the PSQ alone (R2 = 0.301 vs 0.122, respectively). LIMITATIONS: Sensitivity to smell was only assessed by a short questionnaire and could lack relevance. Healthy volunteers were unlikely to elicit psychological risk factors such as anxiety, depression, or catastrophizing. These results have not been validated in a clinical setting (e.g., perioperative). CONCLUSION: The predictive potential of the PSQ can be improved by including information about gender, eye color, and light sensitivity. However, there is still a need for a technique suitable for routine clinical use to assess light sensitivity. KEY WORDS: Personalized medicine, postoperative pain, senses, prediction, photophobia, hyperacusis, eye color, hypervigilance, sensory over-responsivity

scholarly journals Catastrophizing Has a Better Prediction for TMD Than Other Psychometric and Experimental Pain Variables

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lisa Willassen ◽  
Anders Arne Johansson ◽  
Siv Kvinnsland ◽  
Kordian Staniszewski ◽  
Trond Berge ◽  
...  
Keyword(s):  
Pain Catastrophizing ◽  
Conditional Logistic Regression ◽  
Depression Scale ◽  
Experimental Pain ◽  
Masticatory Muscles ◽  
Musculoskeletal Symptoms ◽  
Healthy Individuals ◽  
Conditional Logistic Regression Model ◽  
Pain Thresholds ◽  
Lower Pain

Temporomandibular disorders (TMDs) are characterized by moderate to severe pain in the masticatory muscles and/or the temporomandibular joint (TMJ). The present study is a part of a multidisciplinary project, initiated by the Norwegian Ministry of Health. The main purpose of this study is to compare a cohort of TMD patients to healthy individuals regarding experimental pain, the degree of disability caused by living with pain and psychometric variables, and to investigate which of these variables is the best predictor for TMD patients. We hypothesised that TMD patients have more disability when living with pain and lower pain thresholds than healthy controls, and those psychometric variables are stronger predictors than pain thresholds provoked by experimental pain. Sixty TMD patients were matched by sex and age to sixty healthy individuals without TMD symptoms or other musculoskeletal symptoms in the head and neck region. All subjects completed a questionnaire that included psychometric characteristics, that is, a one- and two-item version of the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale (HADS), and the Roland Morris Scale (RMS), which measures disability when living with pain. They also underwent a clinical examination including the measurement of pain thresholds with electrical and pressure stimuli. The TMD patients had lower pain thresholds for experimental electrical and pressure stimuli compared with the controls ( P  < 0.05 and <0.001, respectively). They also scored higher than healthy individuals with disability living with pain ( P < 0.001 ), anxiety ( P < 0.001 ), depression ( P < 0.001 ), and catastrophizing ( P < 0.001 ). The results for anxiety, depression, and catastrophizing have been published earlier, and the reused data in this study are compared with RMS and pain thresholds. The conditional logistic regression model identified catastrophizing (OR = 2.42, CI 1.22–4.79) as a significant predictor of TMD patients. The results support this hypothesis and indicate that TMD patients have lower pain thresholds and more disability when living with pain compared to healthy individuals, where the strongest prediction for TMD was catastrophizing. Awareness of psychometric disabilities in TMD patients is of importance when considering the choice of treatment.

scholarly journals Functional improvement in hip pathology improves anxiety, depression, and pain catastrophizing: an intricate link between physical and mental well-being

2020 ◽  
Author(s):  
Paul Gudmundsson ◽  
Paul Nakonezny ◽  
Jason Lin ◽  
Rebisi Owhonda ◽  
Heather Richard ◽  
...  
Keyword(s):  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Negative Relationship ◽  
Depression Scale ◽  
Well Being ◽  
Functional Improvement ◽  
Anxiety And Depression ◽  
Patient Reported ◽  
Anxiety Depression ◽  
The Impact

Abstract BackgroundPain catastrophizing, anxiety, and depression represent risk factors that can be treated alongside physical care given to orthopedic patients. While these factors have been shown to be common in patients with hip pathology, there is limited literature that follows these conditions throughout treatment. The purpose of this study was to track psychological factors in patients with various hip pathology to determine if they improved alongside functional measures following treatment.MethodsPatients presenting to a specialist hip clinic were prospectively evaluated for outcomes of pain catastrophizing, anxiety, depression, and hip function. Pre- and post-treatment assessments were undertaken: Pain Catastrophizing Scale, the Hospital Anxiety Depression Scale, the Hip Outcome Survey, and Hip Disability and Osteoarthritis Outcome Score (HOOS). Patient characteristics were recorded. A correlation analysis, using the Spearman partial correlation coefficient (rs), was conducted to evaluate the relationship between change in psychological factors with change in functional outcomes.ResultsA total of 201 patients (78 male, 123 female) were included, with diagnoses of hip dysplasia (n = 35), femoroacetabular impingement (n = 35), lateral trochanteric pain syndrome (n = 9), osteoarthrosis (n = 109), and avascular necrosis of the hip (n = 13). Statistical analysis revealed a significant negative relationship between change in function level (as measured by HOOS ADL) and change in pain catastrophizing (rs = -0.373, p < 0.0001), depression (rs = -0.363, p < 0.0001), and anxiety (rs = -0.264, p = 0.0002). Pain catastrophizing, depression, and anxiety improved with function. Spearman correlation coefficients also revealed that pain catastrophizing, HADS anxiety, and HADS depression improved with improvement in other patient-reported functional outcomes.ConclusionsPatients with hip pathology often exhibit pain catastrophizing, anxiety, and depression, but improvements in hip functionality are associated with decreased severity of these psychological comorbidities. Establishing this connection demonstrates the impact that musculoskeletal impairment has on psychosocial outcomes and mental health. Perioperative multidisciplinary assessment may be a beneficial part of comprehensive orthopaedic hip care.

scholarly journals An experimental investigation of the relationships among race, prayer, and pain

2018 ◽  
Vol 18 (3) ◽  
pp. 545-553 ◽  
Author(s):  
Samantha M. Meints ◽  
Catherine Mosher ◽  
Kevin L. Rand ◽  
Leslie Ashburn-Nardo ◽  
Adam T. Hirsh
Keyword(s):  
Coping Strategies ◽  
Pain Catastrophizing ◽  
Pain Tolerance ◽  
General Tendency ◽  
Race Difference ◽  
Cold Pain ◽  
Passive Coping ◽  
Main Effect ◽  
Pain Outcomes ◽  
Lower Pain

Abstract Background and aims Compared to White individuals, Black individuals demonstrate a lower pain tolerance. Research suggests that differences in pain coping strategies, such as prayer, may mediate this race difference. However, previous research has been cross-sectional and has not determined whether prayer in and of itself or rather the passive nature of prayer is driving the effects on pain tolerance. The aim of this study was to clarify the relationships among race, prayer (both active and passive), and pain tolerance. Methods We randomly assigned 208 pain-free participants (47% Black, 53% White) to one of three groups: active prayer (“God, help me endure the pain”), passive prayer (“God, take the pain away”), or no prayer (“The sky is blue”). Participants first completed a series of questionnaires including the Duke University Religion Index, the Coping Strategies Questionnaire-Revised (CSQ-R), and the Pain Catastrophizing Scale. Participants were then instructed to repeat a specified prayer or distractor coping statement while undergoing a cold pressor task. Cold pain tolerance was measured by the number of seconds that had elapsed while the participant’s hand remained in the cold water bath (maximum 180 s). Results Results of independent samples t-tests indicated that Black participants scored higher on the CSQ-R prayer/hoping subscale. However, there were no race differences among other coping strategies, religiosity, or catastrophizing. Results of a 2 (Race: White vs. Black)×3 (Prayer: active vs. passive vs. no prayer) ANCOVA controlling for a general tendency to pray and catastrophizing in response to prayer indicated a main effect of prayer that approached significance (p=0.06). Pairwise comparisons indicated that those in the active prayer condition demonstrated greater pain tolerance than those in the passive (p=0.06) and no prayer (p=0.03) conditions. Those in the passive and no prayer distractor conditions did not significantly differ (p=0.70). There was also a trending main effect of race [p=0.08], with White participants demonstrating greater pain tolerance than Black participants. Conclusions Taken together, these results indicate that Black participants demonstrated a lower pain tolerance than White participants, and those in the active prayer condition demonstrated greater tolerance than those in the passive and no prayer conditions. Furthermore, Black participants in the passive prayer group demonstrated the lowest pain tolerance, while White participants in the active prayer group exhibited the greatest tolerance. Results of this study suggest that passive prayer, like other passive coping strategies, may be related to lower pain tolerance and thus poorer pain outcomes, perhaps especially for Black individuals. On the other hand, results suggest active prayer is associated with greater pain tolerance, especially for White individuals. Implications These results suggest that understanding the influence of prayer on pain may require differentiation between active versus passive prayer strategies. Like other active coping strategies for pain, active prayer may facilitate self-management of pain and thus enhance pain outcomes independent of race. Psychosocial interventions may help religiously-oriented individuals, regardless of race, cultivate a more active style of prayer to improve their quality of life.

Impact of Psychological Covariates on Experimental Pain Sensitivity in Children and Adolescents with SCD

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 985-985
Author(s):  
Nitya Bakshi ◽  
Ines Lukombo ◽  
Inna Belfer ◽  
Lakshmanan Krishnamurti
Keyword(s):  
Depressive Symptoms ◽  
Psychological Factors ◽  
Pain Sensitivity ◽  
Pain Threshold ◽  
Experimental Pain ◽  
Cold Pain ◽  
Pain Thresholds ◽  
T Score ◽  
Spearman's Rho ◽  
Spearman’S Rho

Abstract Background: Children with Sickle Cell Disease (SCD) have increased sensitivity to heat and cold pain (Brandow et al) during steady state. However, the role of psychological factors such as anxiety, depressive symptoms and catastrophizing on pain sensitivity is not known in SCD. Characterization of these factors may provide an insight into the study of their possible roles in the transition to chronic pain. Aim: To determine if psychological factors impact pain sensitivity in patients with SCD. Methods: Patients with SCD were offered quantitative sensory testing (QST) when at steady state (at least 2 weeks following a VOE). QST procedures included estimation of pressure, mechanical and thermal pain thresholds (minimum intensity of stimulus which is first perceived as painful) and tolerances (maximum intensity of a pain-producing stimulus that a participant is willing to accept in a given situation) as well as windup values (increased pain perception to repetitive painful stimuli). At each time point, participants completed the PROMIS measures of pain intensity, pain interference, anxiety, depressive symptoms, sleep, fatigue and peer relationships. Participants also completed the Pain Catastrophizing Scale ((PCS)-Sullivan et al), Child Somatization Inventory (Walker et al), Pain Coping Inventory (Varni et al)* as well as Peds QL Generic and SCD specific measures of Quality of life*. Results: We determined the experimental pain phenotype (sensitivity to pressure, mechanical and thermal pain) of 29 patients with SCD during steady state (> 2 weeks from a vaso-occlusive episode). These participants were not receiving long-term opioids or adjunctive medications for pain. The median age of participants was 15 (IQR 10-19) and majority (69%) were female. Approximately half of the study sample had HbSS. Three quarters of the study sample were prescribed hydroxyurea. The median Hb level was 11.1 (IQR 10.2-11.6). The median number of VOC's in the year prior to testing was 1(IQR 0-2) and in 3 years prior to testing was 3 (IQR 2-5). The median PROMIS pain intensity T-score was 37.8, PROMIS pain interference T-score was 48.75, PROMIS Depressive symptom T-score was 44.35 and PROMIS anxiety was 43.9; these scores were not higher than the average T-score of 50 described in the pediatric population. High catastrophizing scores were reported on the PCS, with median score being 29. The median cold pain threshold was 23.6 degrees C (IQR 15.8-26.7) and median heat pain threshold was 39.1 degrees C (IQR 37.5-40.9). We noted that increase in scores on PROMIS depressive symptoms was associated with lower heat (Spearman's rho= -0.55), cold (Spearman's rho= 0.57) and mechanical (Spearman's rho= -0.4) pain thresholds. Scores on PROMIS depressive symptoms predicted heat and cold pain thresholds independent of age and VOC's in the past 3 years. Increased PROMIS anxiety scores were associated with lower mechanical pain thresholds (Spearman's rho= -0.43) and lower cold detection thresholds (Spearman's rho= 0.46). Increased scores on PCS were associated with lower heat detection thresholds (Spearman's' rho= -0.39). (All p-values were<0.05) Table 1.OutcomeDepressive symptomsVOCs in 3 years prior to studyAge (years)Model signCoeffp-valueCoeffp-valueCoeffp-valueCold Pain Threshold0.40.003-0.190.6-0.410.16<0.0127Heat Pain Threshold-0.120.0130.380.0120.20.068<0.00128 Conclusions: Depressive symptoms and anxiety are associated with lower experimental pain thresholds in patients with SCD. Higher scores on PROMIS depressive symptoms predict increased sensitivity to heat and cold pain independent of age and number of VOCs experienced in the past 3 years. Further studies are needed to determine the contribution of psychological factors in the transition to chronic pain in SCD. Acknowledgments: 1-Sickle Cell Disease Association of America 2- *PedsQL™ contact information and permission to use: Mapi Research Trust, Lyon, France. E-mail: [email protected] - Internet: www.Mapi-trust.org and http://www.pedsql.org/index.html Disclosures No relevant conflicts of interest to declare.

scholarly journals Functional improvement in hip pathology is related to improvement in anxiety, depression, and pain catastrophizing: an intricate link between physical and mental well-being

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Paul Gudmundsson ◽  
Paul A. Nakonezny ◽  
Jason Lin ◽  
Rebisi Owhonda ◽  
Heather Richard ◽  
...  
Keyword(s):  
Psychological Factors ◽  
Functional Outcomes ◽  
Pain Catastrophizing ◽  
Negative Relationship ◽  
Depression Scale ◽  
Well Being ◽  
Post Treatment ◽  
Anxiety And Depression ◽  
Patient Reported ◽  
Anxiety Depression

Abstract Background Pain catastrophizing, anxiety, and depression are risk factors for poor functional outcomes and worse post-treatment pain that can be treated alongside physical care given to orthopedic patients. While these factors have been shown to be common in patients with hip pathology, there is limited literature that follows these conditions throughout treatment. The purpose of this study was to track psychological factors in patients with various hip pathology to determine if they improved alongside functional measures following treatment. Methods Patients presenting to a specialist hip clinic were prospectively evaluated for outcomes of pain catastrophizing, anxiety, depression, and hip function. Pre- and post-treatment assessments were undertaken: Pain Catastrophizing Scale, the Hospital Anxiety Depression Scale, the Hip Outcome Survey, and Hip Disability and Osteoarthritis Outcome Score (HOOS). Patient characteristics were recorded. A correlation analysis, using the Spearman partial correlation coefficient (rs), was conducted to evaluate the relationship between change in psychological factors with change in functional outcomes. Results A total of 201 patients (78 male, 123 female) with a mean age of 53.75 ± 18.97 years were included, with diagnoses of hip dysplasia (n = 35), femoroacetabular impingement (n = 35), lateral trochanteric pain syndrome (n = 9), osteoarthrosis (n = 109), and avascular necrosis of the hip (n = 13). Statistical analysis revealed a significant negative relationship between change in function level (as measured by HOOS ADL) and change in pain catastrophizing (rs = − 0.373, p < 0.0001), depression (rs = − 0.363, p < 0.0001), and anxiety (rs = − 0.264, p = 0.0002). Pain catastrophizing, depression, and anxiety improved with function. Spearman correlation coefficients also revealed that pain catastrophizing, HADS anxiety, and HADS depression improved with improvement in other patient-reported functional outcomes. Conclusions Patients with hip pathology often exhibit pain catastrophizing, anxiety, and depression, but improvements in hip functionality are associated with decreased severity of these psychological comorbidities. Exploring this connection demonstrates the correlation between musculoskeletal impairment and psychosocial outcomes and mental health. Perioperative multidisciplinary assessment may be a beneficial part of comprehensive orthopaedic hip care.

scholarly journals Static mechanical allodynia in post-surgical neuropathic pain after breast cancer treatments

2020 ◽  
Vol 20 (4) ◽  
pp. 683-691
Author(s):  
Laura Mustonen ◽  
Tommi Aho ◽  
Hanna Harno ◽  
Eija Kalso
Keyword(s):  
Breast Cancer ◽  
Neuropathic Pain ◽  
Psychological Factors ◽  
Mechanical Allodynia ◽  
Cold Pressor Test ◽  
Pain Tolerance ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Cold Pain ◽  
Static Mechanical

AbstractObjectivesStatic mechanical allodynia (SMA), i. e., pain caused by normally non-painful static pressure, is a prevalent manifestation of neuropathic pain (NP). Although SMA may significantly affect the patient’s daily life, it is less well studied in the clinical context. We aimed to characterize SMA in women with chronic post-surgical NP (CPSNP) after breast cancer surgery. Our objective was to improve understanding of the clinical picture of this prevalent pain condition. This is a substudy of a previously published larger cohort of patients with intercostobrachial nerve injury after breast cancer surgery (Mustonen et al. Pain. 2019;160:246–56).MethodsWe studied SMA in 132 patients with CPSNP after breast cancer surgery. The presence, location, and intensity of SMA were assessed at clinical sensory examination. The patients gave self-reports of pain with the Brief Pain Inventory (BPI). We studied the association of SMA to type of surgery, oncological treatments, BMI, other pains, and psychological factors. General pain sensitivity was assessed by the cold pressor test.ResultsSMA was prevalent (84%) in this cohort whereas other forms of allodynia were scarce (6%). Moderate-to-severe SMA was frequently observed even in patients who reported mild pain in BPI. Breast and the side of chest were the most common locations of SMA. SMA was associated with breast surgery type, but not with psychological factors. Severe SMA, but not self-reported pain, was associated with lower cold pain tolerance.ConclusionsSMA is prevalent in post-surgical NP after breast cancer surgery and it may represent a distinct NP phenotype. High intensities of SMA may signal the presence of central sensitization.ImplicationsSMA should be considered when examining and treating patients with post-surgical NP after breast cancer surgery.

scholarly journals Effectiveness of perioperative pain science education on pain, psychological factors and physical functioning: A systematic review

2021 ◽  
pp. 026921552110068
Author(s):  
Elien Van der Gucht ◽  
Lore Dams ◽  
Vincent Haenen ◽  
Lode Godderis ◽  
Bart Morlion ◽  
...  
Keyword(s):  
Science Education ◽  
Physical Functioning ◽  
Psychological Factors ◽  
Pain Catastrophizing ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
P Value ◽  
Preoperative Pain ◽  
Registration Number

Objective: To synthesize the evidence on the effectiveness of pain science education on pain, psychological factors and physical functioning in adults who underwent surgery. Data sources: A systematic literature search of English articles using PubMed/Medline, Embase, Web of Science Core Collection, and Cochrane Library. Review methods: The search strategy was constructed as follows: (((pain) AND (education)) OR (pain education)) AND (surgery). Only controlled quantitative studies in adults reporting outcome(s) on pain, psychological factors and/or physical functioning were included. Risk of bias was assessed using the Cochrane risk of bias tools. P-values and corresponding effect sizes for interaction-effect (time × group) portrayed the difference in change over time between groups were of interest. The last search was conducted on February 28, 2021. Results: Nine papers ( n = 1078) were deemed eligible for this review. Two randomized controlled trials showed significant interaction effects. Breast cancer patients who had received one preoperative pain science education session showed a significant increase in postoperative pain compared to controls ( P-value = 0.0394). Furthermore, p sychological factors (pain catastrophizing and kinesiophobia) decreased in participants who had received pain science education before total knee arthroplasty, while this was not the case in the control group ( P-value < 0.001, ƞ2p:0.11). Conclusions: Overall, pain science education did not result in any significant postoperative effects on pain, psychological factors and/or physical functioning compared to controls. There is currently no strong evidence for the implementation of pain science education in the perioperative period. Registration number: PROSPERO: ID 161267, registration number CRD42020161267

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