Highlights
- •Somatic awareness is an emerging concept in pain research.
- •Somatic awareness is associated with higher tender point count.
- •Somatic awareness mediates the relationship between distress and tender point count.
Abstract
Somatic awareness (SA) refers to heightened sensitivity to a variety of physical sensations
and symptoms. Few attempts have been made to dissociate the relationship of SA and
affective symptoms with pain outcomes. We used a validated measure of mood and anxiety
symptoms that includes questions related to SA to predict the number of tender points
found on physical examination in a large cross-sectional community sample (the Midlife
in the United States [MIDUS] Biomarker study). General distress, positive affect,
and SA, which were all significantly associated with tender point number in bivariate
analyses, were used as predictors of the number of tender points in a multivariate
negative binomial regression model. In this model a greater number of tender points
was associated with higher levels of SA (P = .02) but not general distress (P = .13) or positive affect (P = .50). Follow-up mediation analyses indicated that the relationship between general
distress and tender points was partially mediated by levels of SA. Our primary finding
was that SA is strongly related to the number of tender points in a community sample.
Mechanisms linking SA to the spatial distribution of pain sensitivity should be investigated
further.
Perspective
This article presents an analysis of 3 overlapping psychological constructs and their
relationship to widespread pain sensitivity on palpation. The findings suggest that
SA is most strongly related to the spatial distribution of pain sensitivity and that
further assessing it may improve our understanding of the relationship between psychological
factors and pain.
Key words
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Article info
Publication history
Published online: August 30, 2016
Accepted:
August 19,
2016
Received in revised form:
August 18,
2016
Received:
May 31,
2016
Footnotes
This work was funded by the National Institute on Aging (grant number: P01-AG020166). The original study was supported, in part, by the John D. and Catherine T. MacArthur Foundation Research Network on Successful Midlife Development. A.S. and D.E.H. were supported in part by the National Institute of Dental and Craniofacial Research (grant number: K12 DE023574).
S.E.H. has received research funding from Cerephex, Forest Laboratories, Eli Lily, and Merck; and served as a consultant for Pfizer, Analgesic Solutions, Aptinyx, and deCode Genetics. D.A.W. is currently the President of the American Pain Society; he has served as a consultant with Pfizer Inc and with Community Health Focus Inc. A.L.H. is a consultant for Precision Health Economics and Happify, Inc. She has also had research funded by Bristol-Myers Squibb and Pfizer, Inc. The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
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© 2016 by the American Pain Society
