Attentional and emotional mechanisms of pain processing and their related factors: a structural equations approach.
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.
Huber
Claudia
C
Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany. claudia.huber@uni-bamberg.de
Kunz
Miriam
M
Artelt
Cordula
C
Lautenbacher
Stefan
S
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
D006854:Hydrocortisone
Eur J Pain. 2001;5(2):135-44
11465979
J Psychosom Res. 2008 May;64(5):469-78
18440399
Pain. 1994 Oct;59(1):79-83
7854806
J Pain. 2003 Aug;4(6):322-8
14622689
J Rehabil Med. 2009 Jul;41(8):620-5
19565155
Scand J Psychol. 2002 Apr;43(2):131-7
12004950
Proc Natl Acad Sci U S A. 2006 Apr 4;103(14):5585-90
16567641
Pain. 2000 Apr;85(3):317-332
10781906
Psychoneuroendocrinology. 2009 Jul;34(6):884-93
19195792
Behav Res Ther. 2003 Oct;41(10):1163-82
12971938
J Behav Med. 2000 Aug;23(4):351-65
10984864
J Pain. 2007 Jan;8(1):11-8
17207740
Psychosom Med. 1999 Mar-Apr;61(2):197-204
10204973
Pain. 2007 Jan;127(1-2):27-34
16963183
Pain. 2003 Jul;104(1-2):85-91
12855317
Clin J Pain. 2004 Mar-Apr;20(2):98-102
14770049
Psychophysiology. 2002 Nov;39(6):723-32
12462500
Pain. 2004 Feb;107(3):234-241
14736586
Pharmacol Biochem Behav. 2001 Feb;68(2):203-10
11267624
Psychoneuroendocrinology. 1994;19(4):313-33
8047637
Clin J Pain. 2009 Feb;25(2):92-100
19333152
Behav Res Ther. 2002 Jan;40(1):85-103
11764761
Pain. 2004 Jul;110(1-2):103-11
15275757
Psychol Bull. 1999 May;125(3):356-66
10349356
Pain. 2001 Mar;91(1-2):91-100
11240081
Psychoneuroendocrinology. 2005 Nov;30(10):996-1002
15958280
Clin J Pain. 2005 Jan-Feb;21(1):83-90
15599135
Behav Res Ther. 2002 Sep;40(9):1081-90
12296493
Pain Res Manag. 2005 Winter;10(4):191-200
16341306
Clin J Pain. 2003 Mar-Apr;19(2):125-33
12616183
Pain. 1991 Dec;47(3):249-283
1784498
Psychoneuroendocrinology. 1998 Oct;23(7):741-7
9854745
J Abnorm Psychol. 1992 Feb;101(1):206-7
1537968
Psychoneuroendocrinology. 2003 Jan;28(1):35-47
12445835
Clin J Pain. 2006 Feb;22(2):160-6
16428950
Eur J Pain. 2006 Jul;10(5):457-65
16095935
Clin J Pain. 2007 Sep;23(7):558-64
17710004
Clin J Pain. 2001 Mar;17(1):52-64
11289089
J Pain. 2008 Sep;9(9):806-12
18486557
Psychoneuroendocrinology. 2000 Aug;25(6):577-91
10840170
Pain. 2009 May;143(1-2):123-9
19304392
J Pain. 2008 Apr;9(4):311-9
18165160
Scand J Clin Lab Invest. 2008;68(6):448-58
18609093
Clin J Pain. 2004 May-Jun;20(3):164-73
15100592
Am J Physiol Regul Integr Comp Physiol. 2006 Aug;291(2):R245-56
16484434
Pain. 2003 Feb;101(3):299-306
12583873
Eur J Pain. 2002;6(5):331-9
12160507
Pain. 2009 Feb;141(3):215-221
19121558
J Psychosom Res. 1999 Nov;47(5):403-10
10624838
J Pain. 2006 May;7(5):346-57
16632324
J Pain. 2004 Jun;5(5):250-6
15219256
Life Sci. 1997;61(26):2539-49
9416776
Psychoneuroendocrinology. 2007 Aug;32(7):793-802
17604912
J Clin Endocrinol Metab. 2009 Oct;94(10):3647-55
19602555
J Pain. 2005 Aug;6(8):497-506
16084464
J Behav Med. 2004 Apr;27(2):167-83
15171105
Pain. 1997 Aug;72(1-2):209-15
9272805
Pain. 1996 Aug;66(2-3):133-44
8880834
J Nerv Ment Dis. 1995 Jan;183(1):15-23
7807064
Physiol Res. 2008;57 Suppl 1:S193-9
18271677
Pain. 2007 Jan;127(1-2):121-8
16971044
Psychosom Med. 2007 Dec;69(9):860-3
18040095
Pain. 2009 Nov;146(1-2):47-55
19592167
Pain. 1992 Jul;50(1):67-73
1513605