Dispositional and situational personal features and acute post-collision head and neck pain: Double mediation of pain catastrophizing and pain sensitivity.

Michal Granot,Einav Srulovici,Yelena Granovsky,Pora Kuperman,David Yarnitsky,Inmaculada Riquelme

doi:10.1371/journal.pone.0262076

Abstract

Pain variability can be partially attributed to psycho-cognitive features involved in its processing. However, accumulating research suggests that simple linear correlation between situational and dispositional factors may not be sufficiently explanatory, with some positing a role for mediating influences. In addition, acute pain processing studies generally focus on a post-operative model with less attention provided to post-traumatic injury. As such, this study aimed to investigate a more comprehensive pain processing model that included direct and indirect associations between acute pain intensity in the head and neck, pain catastrophizing (using pain catastrophizing scale (PCS)), and pain sensitivity (using the pain sensitivity questionnaire (PSQ)), among 239 patients with post-motor vehicle collision pain. The effect of personality traits (using Ten Items Personality Inventory (TIPI)) and emotional status (using Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS)) on that model was examined as well. To this end, three Structural Equation Modeling (SEM) analyses were conducted. Overall, the data had good fit to all the models, with only PSQ found to have a direct correlation with acute pain intensity. The SEM analyses conversely revealed several mediations. Specifically, that: first, PSQ fully mediated the relationship between PCS and pain intensity; second, PCS and PSQ together fully mediated the relationship between conscientiousness (personality trait) and pain intensity; and finally, emotional status had direct and indirect links with PSQ and pain intensity. In conclusion, these models suggest that during the acute post-collision phase, pain sensitivity intermediates between emotional states and personality traits, partially via elevated pain catastrophizing thoughts.

Highlights

Half of individuals who suffer acute pain due to injury resultant from motor vehicle collisions will go on to report chronic pain [1, 2]
This study aimed to investigate a more comprehensive pain processing model that included direct and indirect associations between acute pain intensity in the head and neck, pain catastrophizing (using pain catastrophizing scale (PCS)), and pain sensitivity (using the pain sensitivity questionnaire (PSQ)), among 239 patients with post-motor vehicle collision pain
To quantify PC, the Pain Catastrophizing Scale (PCS) was developed to incorporate feature of rumination, magnification, and helplessness toward pain, assumed to attain either situational or dispositional elements [7, 8]. While the latter is considered as a stable characteristic, the former might be manifested in more flexible manner, such that under particular circumstances, the expression of situational features may be altered after an exposure to a demanding situation in either a short- or long-term manner

Summary

Introduction

Half of individuals who suffer acute pain due to injury resultant from motor vehicle collisions will go on to report chronic pain [1, 2]. To quantify PC, the Pain Catastrophizing Scale (PCS) was developed to incorporate feature of rumination, magnification, and helplessness toward pain, assumed to attain either situational or dispositional elements [7, 8]. While the latter is considered as a stable characteristic, the former might be manifested in more flexible manner, such that under particular circumstances, the expression of situational features may be altered after an exposure to a demanding situation in either a short- or long-term manner. Dispositional PC can be linked with pain intensity in the case that the nociceptive stimulus or the painful event evokes enhanced situational PC and vice versa [8,9,10]

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Discussion

Conclusion