Acceptance-Based Emotion Regulation Reduces Subjective and Physiological Pain Responses.

Valentina Haspert,Philipp Reicherts,Matthias J Wieser,Paul Pauli

doi:10.3389/fpsyg.2020.01514

Abstract

Acceptance-based regulation of pain, which focuses on the allowing of pain and pain related thoughts and emotions, was found to modulate pain. However, results so far are inconsistent regarding different pain modalities and indices. Moreover, studies so far often lack a suitable control condition, focus on behavioral pain measures rather than physiological correlates, and often use between-subject designs, which potentially impede the evaluation of the effectiveness of the strategies. Therefore, we investigated whether acceptance-based strategies can reduce subjective and physiological markers of acute pain in comparison to a control condition in a within-subject design. To this end, participants (N = 30) completed 24 trials comprising 10 s of heat pain stimulation. Each trial started with a cue instructing participants to welcome and experience pain (acceptance trials) or to react to the pain as it is without employing any regulation strategies (control trials). In addition to pain intensity and unpleasantness ratings, heart rate (HR) and skin conductance (SC) were recorded. Results showed significantly decreased pain intensity and unpleasantness ratings for acceptance compared to control trials. Additionally, HR was significantly lower during acceptance compared to control trials, whereas SC revealed no significant differences. These results demonstrate the effectiveness of acceptance-based strategies in reducing subjective and physiological pain responses relative to a control condition, even after short training. Therefore, the systematic investigation of acceptance in different pain modalities in healthy and chronic pain patients is warranted.

Highlights

Pain is an unpleasant sensory and emotional experience (Merskey and Bogduk, 2016), sometimes even referred to as an emotion that involves a physical sensation (Price, 1999; Wieser and Pauli, 2016)
Analysis of pain intensity revealed a significant effect of condition, t(29) = 3.23, p = 0.003, dav = 0.217, indicating lower pain intensity ratings for the acceptance compared to the control condition
We found that an acceptance-based pain regulation strategy led to a reduced perception of acute heat pain compared to a carefully instructed control condition as indicated by pain intensity and unpleasantness ratings

Summary

Introduction

Pain is an unpleasant sensory and emotional experience (Merskey and Bogduk, 2016), sometimes even referred to as an emotion that involves a physical sensation (Price, 1999; Wieser and Pauli, 2016). The general goal of ACT is to increase psychological flexibility – the ability to stay present in the moment and to change or persist value-based behavior (Hayes et al, 2006). Acceptance (Hayes et al, 1999; Hofmann et al, 2009; Braams et al, 2012; Kohl et al, 2013) involves the active and aware embrace of events and is one of six core ACT processes underlying psychological flexibility (Hayes et al, 2006). Two closely related ACT processes and widely used conceptualizations of acceptancebased strategies in emotion and pain regulation research are mindfulness (“being present” and “non-judgmental”) (Braams et al, 2012; Kohl et al, 2013) and cognitive defusion (“decrease in believability of or attachment to an event”) (Kohl et al, 2013)

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Results

Conclusion