title: Attentional and emotional mechanisms of pain processing and their related factors: a structural equations approach.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany. claudia.huber@uni-bamberg.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Huber
authors.forename: Miriam
authors.initials: M
authors.lastname: Kunz
authors.forename: Cordula
authors.initials: C
authors.lastname: Artelt
authors.forename: Stefan
authors.initials: S
authors.lastname: Lautenbacher
mesh_terms: D000161:Acoustic Stimulation / Q000009:adverse effects; D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000523:psychology*; D019540:Area Under Curve; D001289:Attention Deficit Disorder with Hyperactivity / Q000209:etiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D016013:Likelihood Functions; D008297:Male; D008960:Models, Psychological; D010146:Pain / Q000150:complications* / Q000378:metabolism / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000523:psychology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012463:Saliva / Q000378:metabolism; D012649:Self Concept; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
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