Abstract
BackgroundUncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression. The high comorbidity of depression and pain symptoms and the importance of controllability in both conditions are clinically well-known but empirical studies are scarce. The study investigated the relationship of pain experience, helplessness, and cortisol secretion after controllable vs. uncontrollable electric skin stimulation in healthy male individuals.MethodsSixty-four male volunteers were randomly assigned to receive 30 controllable (self-administered) or uncontrollable (experimenter-administered) painful electric skin stimuli. Perceived pain intensity (PPI), subjective helplessness ratings, and salivary cortisol concentrations were assessed. PPI was assessed after stress exposure. For salivary cortisol concentrations and subjective helplessness ratings, areas under the response curve (AUC) were calculated.ResultsAfter uncontrollable vs. controllable stress exposure significantly higher PPI ratings (P = 0.023), higher subjective helplessness AUC (P < 0.0005) and higher salivary cortisol AUC (P = 0.004, t-tests) were found. Correlation analyses revealed a significant correlation between subjective helplessness AUC and PPI (r = 0.500, P < 0.0005), subjective helplessness AUC and salivary cortisol AUC (r = 0.304, P = 0.015) and between PPI and salivary cortisol AUC (r = 0.298, P = 0.017).ConclusionsThe results confirm the impact of uncontrollability on stress responses in humans; the relationship of PPI with subjective helplessness and salivary cortisol suggests a cognitive-affective sensitization of pain perception, particularly under uncontrollable conditions.
Highlights
Uncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression
The present study investigated salivary cortisol responses, subjective helplessness, and pain intensity perception (PPI) to controllable and uncontrollable stress in healthy males using an electric skin stimuli procedure
Under the uncontrollable stress condition, a sharp increase of subjective helplessness ratings occurred after stress exposure whereas the subjective helplessness ratings values after the controllable condition decreased
Summary
Uncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression. Learned helplessness theory has shown that repeated exposure to non-contingent feedback, i.e. a lack of correlation between behavior and aversive consequences may lead to negative affective, motivational, and cognitive sequelae including blunted and lowered affect, hopelessness, low self-esteem, motivational deficits and a cognitive bias towards low self-efficacy and controllability expectancies [4,5]. Besides these psychological effects of experiencing uncontrollable stress, activation of the hypothalamic-. Painful stimuli were used because the main focus of the present study was the PPI in relation to experimentally induced uncontrollability and not the pain induction per se
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