title: Catastrophizing delays the analgesic effect of distraction.
abstract: Behavioral analgesic techniques such as distraction reduce pain in both clinical and experimental settings. Individuals differ in the magnitude of distraction-induced analgesia, and additional study is needed to identify the factors that influence the pain relieving effects of distraction. Catastrophizing, a set of negative emotional and cognitive processes, is widely recognized to be associated with increased reports of pain. We sought to evaluate the relationship between catastrophizing and distraction analgesia. Healthy participants completed three sessions in a randomized order. In one session (Pain Alone), pain was induced by topical application of a 10% capsaicin cream and simultaneous administration of a tonic heat stimulus. In another session (Pain+Distraction), identical capsaicin+heat application procedures were followed, but subjects played video games that required a high level of attention. During both sessions, verbal ratings of pain were obtained and participants rated their degree of catastrophizing. During the other session (Distraction Alone) subjects played the video games in the absence of any pain stimulus. Pain was rated significantly lower during the distraction session compared to the "Pain Alone" session. In addition, high catastrophizers rated pain significantly higher regardless of whether the subjects were distracted. Catastrophizing did not influence the overall degree of distraction analgesia; however, early in the session high catastrophizers had little distraction analgesia, though later in the session low and high catastrophizers rated pain similarly. These results suggest that both distraction and catastrophizing have substantial effects on experimental pain in normal subjects and these variables interact as a function of time.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA Department of Neurosurgery, Johns Hopkins University School of Medicine, USA Department of Anesthesiology, Perioperative and Pain Medicine, Brigham & Women's Hospital, Harvard Medical School, USA Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, USA.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Campbell
authors.forename: Kenny
authors.initials: K
authors.lastname: Witmer
authors.forename: Mpepera
authors.initials: M
authors.lastname: Simango
authors.forename: Alene
authors.initials: A
authors.lastname: Carteret
authors.forename: Marco L
authors.initials: ML
authors.lastname: Loggia
authors.forename: James N
authors.initials: JN
authors.lastname: Campbell
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Haythornthwaite
authors.forename: Robert R
authors.initials: RR
authors.lastname: Edwards
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods* / Q000523:psychology; D001007:Anxiety / Q000150:complications* / Q000523:psychology; D001288:Attention / Q000502:physiology; D001521:Behavior Therapy / Q000379:methods* / Q000706:statistics & numerical data; D002211:Capsaicin / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D010146:Pain / Q000145:classification* / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods / Q000523:psychology; D011930:Reaction Time / Q000502:physiology; D012647:Self-Assessment; D018689:Sensory System Agents / Q000009:adverse effects; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology; D013997:Time Factors; D055815:Young Adult
chemical_list: D018689:Sensory System Agents; D002211:Capsaicin