Abstract
Although large interindividual differences in pain exist, the underlying factors that
contribute to these variations remain poorly understood. Consequently, being able
to accurately explain variability in pain ratings in terms of its contributing factors
could provide insights into developing a better understanding of individual differences
in pain experience. In the present investigation, we show that a significant portion
of the variability in experimental heat pain ratings may be predicted using simple
quantitative sensory testing and a series of psychological questionnaires including
State Trait and Anxiety Inventory (STAI), Center for Epidemiologic Studies – Depression
Scale (CES-D), and Positive and Negative Affect Schedule – Expanded form (PANAS-X).
A factor analysis was used to reduce individual predictors into sets of composite
predictive factors. A multifactorial model that was generated from these factors can
reliably predict a significant amount of the variability in heat pain sensitivity
ratings (r2 = .537, P = .027). Moreover, individual variables including heat pain thresholds and self-assessment
of pain sensitivity were found to be poor predictors of heat pain sensitivity. Taken
together, these results suggest that a variety of factors underlie individual differences
in pain experience and that a reliable model for predicting pain should be constructed
from a combination of these factors.
Perspective
The present study provides a way to predict subjects' experimental heat pain sensitivity
using a multifactorial model generated from a combination of sensory and psychological
factors. Future application of such a model in the studies of clinical pain could
potentially improve the quality of care provided for patients in pain.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of PainAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A comparison of the relationship between depression, perceived disability, and physical performance in persons with chronic pain.Eur J Pain. 2008; 12: 757-764
- Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients.J Oral Maxillofac Surg. 2001; 59: 628-633
- Pain perception in major depression depends on pain modality.Pain. 2005; 117: 97-103
- Chronic pain in neurorehabilitation populations: Prevalence, severity and impact.NeuroRehabilitation. 2000; 14: 127-137
- Analgesic effect of vibration and cooling on pain induced by intraneural electrical stimulation.Pain. 1984; 18: 239-248
- Wide dynamic range but not nociceptive-specific neurons encode multidimensional features of prolonged repetitive heat pain.J Neurophysiol. 1993; 69: 703-716
- Neural correlates of interindividual differences in the subjective experience of pain.Proc Natl Acad Sci U S A. 2003; 100: 8538-8542
- The effect of experimentally induced anxiety on the experience of pressure pain.Pain. 1988; 35: 105-113
- Functional brain interactions that serve cognitive-affective processing during pain and placebo analgesia.Neuroimage. 2007; 38: 720-729
- The dynamic mechanisms of placebo induced analgesia: Evidence of sustained and transient regional involvement.Pain. 2008; 139: 660-669
- Impact of depression on experimental pain perception: A systematic review of the literature with meta-analysis.Psychosom Med. 2003; 65: 369-375
- A peripheral “cold” fiber population responsive to innocuous and noxious thermal stimuli applied to monkey's face.J Neurophysiol. 1975; 38: 1373-1389
- Catastrophizing predicts changes in thermal pain responses after resolution of acute dental pain.J Pain. 2004; 5: 164-170
- Self-reported pain sensitivity: Lack of correlation with pain threshold and tolerance.Eur J Pain. 2007; 11: 594-598
- Studies on the relief of pain by counterirritation.J Clin Invest. 1941; 20: 13-20
- Negative affect, self-report of depressive symptoms, and clinical depression: Relation to the experience of chronic pain.Clin J Pain. 2000; 16: 110-120
- Pain catastrophizing and neural responses to pain among persons with fibromyalgia.Brain. 2004; 127: 835-843
- Cerebral blood flow changes associated with experimental pain stimulation in patients with major depression.J Affect Disord. 2008; 107: 161-168
- Postcesarean section pain prediction by preoperative experimental pain assessment.Anesthesiology. 2003; 98: 1422-1426
- Psychological factors associated with perception of experimental pain in vulvar vestibulitis syndrome.J Sex Marital Ther. 2005; 31: 285-302
- Prospective examination of pain-related and psychological predictors of CRPS-like phenomena following total knee arthroplasty: A preliminary study.Pain. 2003; 106: 393-400
- Psychological aspects of neuropathic pain.Clin J Pain. 2000; 16: S101-S105
- Predicting postoperative pain by preoperative pressure pain assessment.Anesthesiology. 2005; 103: 613-618
- EEG responses to tonic heat pain.Exp Brain Res. 2006; 173: 14-24
- Psychosocial and pharmacologic predictors of satisfaction with intravenous patient-controlled analgesia.Anesth Analg. 1993; 77: 121-125
- The relationship between cognitive appraisal, affect, and catastrophizing in patients with chronic pain.J Pain. 2003; 4: 267-277
- Morphine and ibuprofen compared using the cold pressor test.Pain. 1988; 34: 117-122
- Preoperative prediction of severe postoperative pain.Pain. 2003; 105: 415-423
- Placebo analgesia: Findings from brain imaging studies and emerging hypotheses.Rev Neurosci. 2007; 18: 173-190
- Tonic pain evoked by pulsating heat: Temporal summation mechanisms and perceptual qualities.Somatosens Mot Res. 1995; 12: 59-70
- The effect of analgesic technique on postoperative patient-reported outcomes including analgesia: A systematic review.Anesth Analg. 2007; 105: 789-808
- Stress influences the level of negative affectivity after forehead cold pressor pain.J Pain. 2003; 4: 520-529
- Sensitivity of cutaneous cold fibers to noxious heat: paradoxical cold discharge.J Neurophysiol. 1977; 40: 489-502
- Assessment of patient satisfaction with postoperative pain management after ambulatory gynaecologic laparoscopy.J Obstet Gynaecol Can. 2007; 29: 664-667
- Determinants of pressure pain threshold in adult twins: Evidence that shared environmental influences predominate.Pain. 1997; 73: 253-257
- Age is the best predictor of postoperative morphine requirements.Pain. 1996; 64: 357-364
- Psychological factors and perceptions of pain associated with dental treatment.Community Dent Oral Epidemiol. 2002; 30: 151-159
- The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions.Pain. 2003; 105: 79-88
- Characterizing individual differences in heat-pain sensitivity.Pain. 2005; 119: 65-74
- Individual differences in pain sensitivity: Genetic and environmental contributions.Pain. 2008; 136: 21-29
- Heritability of responses to painful stimuli in women: A classical twin study.Brain. 2007; 130: 3041-3049
- Multifactorial preoperative predictors for postcesarean section pain and analgesic requirement.Anesthesiology. 2006; 104: 417-425
- Hyperalgesia in a human model of acute inflammatory pain: A methodological study.Pain. 1998; 74: 139-151
- Secondary hyperalgesia to heat stimuli after burn injury in man.Pain. 1998; 76: 377-384
- Ondansetron does not inhibit the analgesic effect of alfentanil.Br J Anaesth. 1994; 73: 326-330
- Exacerbation of pain by anxiety is associated with activity in a hippocampal network.J Neurosci. 2001; 21: 9896-9903
- Spatial summation of heat-induced pain: Influence of stimulus area and spatial separation of stimuli on perceived pain sensation intensity and unpleasantness.J Neurophysiol. 1989; 62: 1270-1279
- A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales.Pain. 1994; 56: 217-226
- A comprehensive review of the placebo effect: Recent advances and current thought.Annu Rev Psychol. 2008; 59: 565-590
- The CES-D scale: A self-report depression scale for research in the general population.App Psychol Meas. 1977; 1: 385-401
- Fear and anxiety: Divergent effects on human pain thresholds.Pain. 2000; 84: 65-75
- Influences of gender role and anxiety on sex differences in temporal summation of pain.J Pain. 2004; 5: 77-82
- Reproducibility of pain measurement and pain perception.Pain. 2002; 98: 205-216
- The relationship of daily mood and stressful events to symptoms in juvenile rheumatic disease.Arthritis Care Res. 2000; 13: 33-41
- Acute and chronic pain in geriatrics: Clinical characteristics of pain and the influence of cognition.Pain Med. 2004; 5: 253-262
- Are poor metabolisers of sparteine/debrisoquine less pain tolerant than extensive metabolisers?.Pain. 1993; 53: 335-339
- Roles of the insular cortex in the modulation of pain: Insights from brain lesions.J Neurosci. 2009; 29: 2684-2694
- Ratings of experimental pain and pain-related negative affect predict clinical pain in patients with fibromyalgia syndrome.Pain. 2003; 105: 215-222
- Body pain area and pain-related negative affect predict clinical pain intensity in patients with fibromyalgia.J Pain. 2004; 5: 338-343
- Theoretical perspectives on the relation between catastrophizing and pain.Clin J Pain. 2001; 17: 52-64
- Psychological factors in chronic pain: evolution and revolution.J Consult Clin Psychol. 2002; 70: 678-690
- The Panas: X Manual for the Positive and Negative Schedule: Expanded Form.University of Iowa, Iowa City1991
- Prediction of postoperative pain by preoperative nociceptive responses to heat stimulation.Anesthesiology. 2004; 100: 115-119
- Neurocognitive aspects of pain perception.Trends Cogn Sci. 2008; 12: 306-313
- Gender role expectations of pain: Relationship to experimental pain perception.Pain. 2002; 96: 335-342
- Hubbard D: Transition from acute to chronic pain and disability: A model including cognitive, affective, and trauma factors.Pain. 2008; 134: 69-79
Article info
Publication history
Published online: June 07, 2010
Accepted:
March 21,
2010
Received in revised form:
March 15,
2010
Received:
April 24,
2009
Footnotes
Supported by NIHR01 NS39426 and DA20168.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
