What do you expect? Catastrophizing mediates associations between expectancies and pain-facilitatory processes.
Journal
European journal of pain (London, England)
ISSN: 1532-2149
Titre abrégé: Eur J Pain
Pays: England
ID NLM: 9801774
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
05
06
2018
revised:
27
11
2018
accepted:
27
11
2018
pubmed:
7
12
2018
medline:
14
6
2019
entrez:
4
12
2018
Statut:
ppublish
Résumé
Pain expectancies are associated with altered pain sensitivity in individuals with chronic pain. However, little is known about the processes by which pain expectancies impact pain processing. This study assessed the association between pain expectancies and temporal summation (TS) of pain, and examined whether pain catastrophizing mediated this association. In this cross-sectional study, participants (437 chronic low back pain [CLBP] patients, 115 controls) completed self-report measures of pain intensity, pain expectancies and pain catastrophizing before undergoing psychophysical pain-testing procedures designed to assess mechanical TS of mechanical pain. Pearson's correlations examined the associations between study variables in CLBP patients and controls. Bootstrapping mediation analyses assessed the mediating role of pain catastrophizing on the association between pain expectancies and TS of pain. Temporal summation of pain was significantly associated with pain expectancies (r = 0.113) and pain catastrophizing (r = 0.171) in CLBP patients. Results of mediation analyses revealed that pain catastrophizing mediated the relationship between pain expectancies and TS of pain in CLBP patients (ab = 0.309, 95% CI = 0.1222-0.5604), but not in healthy controls (ab = -0.125, 95% CI = -0.5864 to 0.0244). The findings from this study suggest that compared to controls, CLBP patients show increased sensitivity to mechanical pain procedures and enhanced pain-facilitatory processing, proving further evidence for changes in central nervous system pain processing in CLBP patients. Our results also suggest that pain catastrophizing may be the mechanism by which pain expectancies are associated with TS of pain in CLBP patients. Individuals with chronic low back pain who expect higher levels of pain and catastrophize about their pain are more likely to experience altered pain sensitivity. Our results point to catastrophizing as a mechanism of action through which psychological factors may operate and lead to the development and maintenance of chronic low back pain.
Sections du résumé
BACKGROUND
BACKGROUND
Pain expectancies are associated with altered pain sensitivity in individuals with chronic pain. However, little is known about the processes by which pain expectancies impact pain processing. This study assessed the association between pain expectancies and temporal summation (TS) of pain, and examined whether pain catastrophizing mediated this association.
METHODS
METHODS
In this cross-sectional study, participants (437 chronic low back pain [CLBP] patients, 115 controls) completed self-report measures of pain intensity, pain expectancies and pain catastrophizing before undergoing psychophysical pain-testing procedures designed to assess mechanical TS of mechanical pain. Pearson's correlations examined the associations between study variables in CLBP patients and controls. Bootstrapping mediation analyses assessed the mediating role of pain catastrophizing on the association between pain expectancies and TS of pain.
RESULTS
RESULTS
Temporal summation of pain was significantly associated with pain expectancies (r = 0.113) and pain catastrophizing (r = 0.171) in CLBP patients. Results of mediation analyses revealed that pain catastrophizing mediated the relationship between pain expectancies and TS of pain in CLBP patients (ab = 0.309, 95% CI = 0.1222-0.5604), but not in healthy controls (ab = -0.125, 95% CI = -0.5864 to 0.0244).
CONCLUSIONS
CONCLUSIONS
The findings from this study suggest that compared to controls, CLBP patients show increased sensitivity to mechanical pain procedures and enhanced pain-facilitatory processing, proving further evidence for changes in central nervous system pain processing in CLBP patients. Our results also suggest that pain catastrophizing may be the mechanism by which pain expectancies are associated with TS of pain in CLBP patients.
SIGNIFICANCE
CONCLUSIONS
Individuals with chronic low back pain who expect higher levels of pain and catastrophize about their pain are more likely to experience altered pain sensitivity. Our results point to catastrophizing as a mechanism of action through which psychological factors may operate and lead to the development and maintenance of chronic low back pain.
Identifiants
pubmed: 30506913
doi: 10.1002/ejp.1348
pmc: PMC6420376
mid: NIHMS1000143
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
800-811Subventions
Organisme : NIA NIH HHS
ID : R01 AG034982
Pays : United States
Organisme : NIDA NIH HHS
ID : R21 DA041020
Pays : United States
Organisme : NIAMS NIH HHS
ID : T32 AR055885
Pays : United States
Informations de copyright
© 2018 European Pain Federation - EFIC®.
Références
Eur J Pain. 2007 May;11(4):415-20
pubmed: 16815054
Pain. 2003 Mar;102(1-2):87-95
pubmed: 12620600
J Pain. 2004 Apr;5(3):164-70
pubmed: 15106129
Neurology. 2005 Aug 9;65(3):437-43
pubmed: 16087910
Eur J Pain. 2006 Aug;10(6):551-7
pubmed: 16199189
Pain. 2002 Apr;96(3):319-24
pubmed: 11973004
Pain. 2007 Jul;130(1-2):137-43
pubmed: 17215080
Pain. 2004 Jan;107(1-2):70-6
pubmed: 14715391
Pain. 2001 Nov;94(2):149-58
pubmed: 11690728
J Pain Symptom Manage. 2011 Jun;41(6):1073-93
pubmed: 21621130
Neurosci Lett. 2012 Jun 29;520(2):140-8
pubmed: 22465136
Behav Res Methods. 2008 Aug;40(3):879-91
pubmed: 18697684
Clin J Pain. 2006 Oct;22(8):730-7
pubmed: 16988570
Arthritis Rheum. 2006 Apr 15;55(2):325-32
pubmed: 16583384
J Neurosci. 2002 Apr 1;22(7):2748-52
pubmed: 11923440
Eur J Pain. 2018 Feb;22(2):426-436
pubmed: 29082638
Behav Res Ther. 1995 Jan;33(1):49-53
pubmed: 7872936
CMAJ. 2002 Mar 19;166(6):749-54
pubmed: 11944761
Pain. 2008 Aug 15;138(1):22-8
pubmed: 18079062
Eur Spine J. 2008 Mar;17(3):380-385
pubmed: 18172698
Pain. 2001 Mar;91(1-2):147-54
pubmed: 11240087
Health Psychol. 2001 Mar;20(2):112-9
pubmed: 11315728
Pain. 2017 Jul;158(7):1224-1233
pubmed: 28328575
J Pain. 2013 Feb;14(2):126-35
pubmed: 23218934
Pain. 1998 Apr;75(2-3):187-98
pubmed: 9583754
Pain Med. 2016 Oct;17(10):1882-1891
pubmed: 26933094
MMWR Morb Mortal Wkly Rep. 2009 May 1;58(16):421-6
pubmed: 19407734
Pain Res Manag. 2017;2017:7892494
pubmed: 28348505
J Occup Rehabil. 2006 Mar;16(1):95-108
pubmed: 16688486
J Arthroplasty. 2009 Aug;24(5):716-21
pubmed: 18701241
Behav Res Methods Instrum Comput. 2004 Nov;36(4):717-31
pubmed: 15641418
Pain. 2008 Jul 31;137(3):609-22
pubmed: 18079063
J Pain Symptom Manage. 2013 Jul;46(1):30-42
pubmed: 23102562
PLoS One. 2014 Feb 18;9(2):e89086
pubmed: 24558475
Eur J Pain. 2009 Nov;13(10):1043-7
pubmed: 19168380
Anesthesiology. 2014 Dec;121(6):1292-301
pubmed: 25264596
Pain. 2011 Oct;152(10):2287-93
pubmed: 21764515
J Pain. 2014 Sep;15(9):967-75
pubmed: 24998695
J Pain. 2007 Jan;8(1):2-10
pubmed: 17207739
Pain. 2011 Apr;152(4):794-801
pubmed: 21316150
Clin J Pain. 2001 Mar;17(1):52-64
pubmed: 11289089
J Neurophysiol. 1997 Aug;78(2):992-1002
pubmed: 9307129
Pain. 2003 Jan;101(1-2):155-65
pubmed: 12507710
Pain. 2002 Nov;100(1-2):111-8
pubmed: 12435464
Psychol Bull. 1991 Jul;110(1):67-85
pubmed: 1891519
J Pain. 2015 Dec;16(12):1280-1287
pubmed: 26409116
Pain. 2016 Jun;157(6):1179-91
pubmed: 26945235
Pain. 2007 Feb;127(3):276-86
pubmed: 17071000
Pain. 2013 Jan;154(1):53-8
pubmed: 23084002
Spine J. 2008 Jan-Feb;8(1):8-20
pubmed: 18164449
Pain Med. 2010 Apr;11(4):591-9
pubmed: 20210869
Ann Behav Med. 2016 Aug;50(4):497-505
pubmed: 26809850
J Occup Rehabil. 2015 Jun;25(2):348-56
pubmed: 25252609
Psychol Methods. 2002 Mar;7(1):83-104
pubmed: 11928892
Arthritis Res Ther. 2009;11(3):R61
pubmed: 19413909
Eur J Pain. 2014 Jan;18(1):86-91
pubmed: 23754275
Bull World Health Organ. 2003;81(9):646-56
pubmed: 14710506
Pain. 2010 Nov;151(2):440-6
pubmed: 20797819
Community Dent Oral Epidemiol. 1998 Oct;26(5):344-9
pubmed: 9792127
J Spinal Disord Tech. 2010 Oct;23(7):451-6
pubmed: 20414134
Science. 1999 Jun 18;284(5422):1979-81
pubmed: 10373114
Psychol Methods. 2002 Dec;7(4):422-45
pubmed: 12530702
Pain. 2004 Feb;107(3):220-6
pubmed: 14736584
J Neurosci. 2015 Jul 1;35(26):9689-700
pubmed: 26134651
Eur J Pain. 2017 Aug;21(7):1234-1242
pubmed: 28493479
J Behav Med. 2014 Feb;37(1):47-58
pubmed: 23239369