(970): Relationships among anxious symptomology, anxiety sensitivity and laboratory pain response in children

Abstract

Anxiety sensitivity (AS) refers to the specific tendency to interpret arousal sensations (e.g., shortness of breath, rapid heart beat) as leading to harmful physical, psychological or social consequences. Previous work in adults has suggested that AS increases an individual’s propensity to experience pain-related anxiety which in turn enhances laboratory pain responsivity. Such relationships have not been examined in younger populations. Thus, the present study used structural equation modeling (SEM) to test a conceptual model in which AS would evidence an indirect relationship with pain intensity via its contribution to state-specific anticipatory anxiety in relation to a variety of laboratory pain tasks (cold pressor, thermal heat, and pressure pain) in 234 healthy children (116 girls; mean age= 12.6 years, range= 8-18 years). The model further hypothesized that existing anxious symptomology would demonstrate a direct relationship with pain intensity. The proposed conceptual model fit the data well (Satorra-Bentler Scaled chi-square (15, N=234)= 17.60, p=0.28, CFI= 0.97, NNFI=0.94, RMSEA=0.027). As expected, AS did not evidence a direct relationship with pain intensity but instead demonstrated a significant indirect effect on pain intensity through pain-related anticipatory anxiety. The total indirect effect of AS accounted for 29% of the variance in laboratory pain intensity via its effects on anticipatory anxiety. Anxious symptomology on the other hand, demonstrated a significant direct effect on pain intensity, accounting for 15% of variance. The combined effects of AS, anxiety symptoms, and anticipatory anxiety together explained 62% of the variance in pain intensity. These relationships did not differ for boys and girls indicating no moderating effect of sex in the conceptual model. The present results support the potential benefit of assessing both AS and anxiety symptoms in children prior to undergoing painful stimulation such as that induced by routine medical procedures.