(314) Pain catastrophizing is associated with threat-enhanced pain in women

Abstract

Catastrophizing is related to pain perception but not spinal nociception (as assessed by the nociceptive flexion reflex; NFR). This implies catastrophizing enhances pain at the brain level not the spinal level. Furthermore, catastrophizing may explain some sex differences in pain given evidence that women engage in more catastrophic thoughts. The present study extended this work and examined the relationship between catastrophizing and pain outcomes (pain, NFR) during a threat paradigm. In this paradigm, participants were exposed to four 30-s danger trials and four 30-s safe trials (order randomized). During danger trials, the text “Danger: Abdominal Stimulation May Be Given at Any Time” was presented on a computer monitor and during two trials the participant received a painful abdomen stimulation. During safe trials, “Safe: No Abdominal Stimulation Will Be Given” was presented and no painful abdomen stimulations were delivered. During all 8 trials, painful electric stimulations were delivered to the ankle to evoke pain and NFR. After all 8 trials, participants rated their pain to ankle stimulations separately for threat and safe trials, and were administered the Pain Catastrophizing Scale to assess situation-specific catastrophizing. Results indicated pain and NFRs were higher during threat than safe trials, indicating threat-enhanced pain and spinal nociception. Change scores (threat minus safe) were created for both variables and used as dependent variables in regression models that included catastrophizing, sex, and the Catastrophizing x Sex interaction as predictors. There were no significant predictors of threat-enhanced NFR. However, the interaction was significant in the prediction of threat-enhanced pain and indicated catastrophizing was associated with greater threat-enhanced pain, but only in women. These results provide further support that catastrophizing does not enhance pain processing at the spinal level, and extend prior studies to show catastrophizing may have a sex-dependent effect on pain enhanced by threatening contexts. Catastrophizing is related to pain perception but not spinal nociception (as assessed by the nociceptive flexion reflex; NFR). This implies catastrophizing enhances pain at the brain level not the spinal level. Furthermore, catastrophizing may explain some sex differences in pain given evidence that women engage in more catastrophic thoughts. The present study extended this work and examined the relationship between catastrophizing and pain outcomes (pain, NFR) during a threat paradigm. In this paradigm, participants were exposed to four 30-s danger trials and four 30-s safe trials (order randomized). During danger trials, the text “Danger: Abdominal Stimulation May Be Given at Any Time” was presented on a computer monitor and during two trials the participant received a painful abdomen stimulation. During safe trials, “Safe: No Abdominal Stimulation Will Be Given” was presented and no painful abdomen stimulations were delivered. During all 8 trials, painful electric stimulations were delivered to the ankle to evoke pain and NFR. After all 8 trials, participants rated their pain to ankle stimulations separately for threat and safe trials, and were administered the Pain Catastrophizing Scale to assess situation-specific catastrophizing. Results indicated pain and NFRs were higher during threat than safe trials, indicating threat-enhanced pain and spinal nociception. Change scores (threat minus safe) were created for both variables and used as dependent variables in regression models that included catastrophizing, sex, and the Catastrophizing x Sex interaction as predictors. There were no significant predictors of threat-enhanced NFR. However, the interaction was significant in the prediction of threat-enhanced pain and indicated catastrophizing was associated with greater threat-enhanced pain, but only in women. These results provide further support that catastrophizing does not enhance pain processing at the spinal level, and extend prior studies to show catastrophizing may have a sex-dependent effect on pain enhanced by threatening contexts.