(107) Pain resilience is positively correlated with nociceptive flexion reflex threshold

Abstract

The Pain Resilience Scale (PRS) has recently been developed as a pain-specific measure of dispositional resilience, or the ability to maintain positive physical and emotional functioning despite pain. The PRS is a 14-item scale that examines an individual’s reported propensity to exhibit resilient responses to prolonged or intense pain. Exploratory and Confirmatory Factor analyses have identified two subscales of the PRS, labeled “Stay Positive” and “Carry On”, which examine cognitive-affective and behavioral-motivational resilience, respectively. Although measures of general (i.e. trait) resilience have previously been related to acute pain experience, the relationship between responses on a pain-specific resilience measure and acute pain perception has not been examined. Accordingly, the current study examined the relationship between pain resilience, as measured by the Pain Resilience Scale, and the Nociceptive Flexion Reflex (NFR) threshold in men and women with and without subclinical pain (n=27). NFR is a polysynaptic withdrawal reflex of the biceps femoris that can be activated by electrical stimulation of the sural nerve. Participants completed measures of pain resilience, pain catastrophizing, and pain-related fear prior to their NFR threshold assessment. NFR threshold was assessed using an up-down staircase method, wherein stimulus intensity was increased until a reflex was detected and then decreased until the reflex disappeared. This procedure was repeated three times to establish a reliable reflex threshold. Results of correlational analyses indicated that the PRS was positively related to NFR threshold (r=0.49, p< .01), whereas pain catastrophizing and pain-related fear were not related to NFR. These findings provide preliminary validation of the PRS in the context of acute experimental pain. Furthermore, the present findings are consistent with existing evidence of no relationship between pain vulnerability (e.g., catastrophizing, anxiety sensitivity) and spinal nociception, and provide novel evidence that pain resilience may be associated with greater descending inhibition of spinal nociception.