Associations between fear-avoidance and endurance responses to pain and salivary cortisol in the context of experimental pain induction

Sudhaus, Sigrid; Held, Sabine Melanie; Schoofs, Daniela; Bültmann, Janina; Dück, Irina; Wolf, Oliver T.; Hasenbring, Monika

doi:10.1016/j.psyneuen.2014.11.011

Cited by 17 publications

(11 citation statements)

References 13 publications

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“…The observed chief role for the HPA axis in this study is in line with previous studies (McLean et al., ; Vachon‐Presseau et al., ; Sudhaus et al., ; Sveinsdottir et al., ). For instance, Vachon‐Presseau et al.…”

Section: Discussionsupporting

confidence: 93%

Fear of pain and cortisol reactivity predict the strength of stress‐induced hypoalgesia

Timmers

Kaas

Quaedflieg

et al. 2018

European Journal of Pain

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BackgroundAcute stress can have an effect on pain sensitivity, yet the direction of the effect – whether it is hypoalgesic or hyperalgesic – is mixed across studies. Moreover, which part of the stress response influences pain sensitivity is still unclear. In the current experimental study, we aim to examine the effect of acute stress on heat pain thresholds and pain tolerance levels in healthy participants, while taking into account individual differences in stress responses.MethodsForty‐two healthy participants were randomly assigned to either a well‐validated stress paradigm: the Maastricht Acute Stress Task (MAST; combining physical and psychological stressors) or to a nonstressful version of the task. Heat pain thresholds and tolerance levels were assessed at three times: prior to the MAST, immediately after the MAST during the presumed sympatho‐adrenal medullary (SAM) response, and 15 min after MAST to cover the presumed hypothalamus–pituitary–adrenal (HPA) axis response. Stress responses were assessed both subjectively and physiologically.ResultsWe observed that the acute stress induction led to increased heat pain thresholds, an effect that was present only in participants showing a cortisol response following stress induction and only in the presumed HPA axis time window. The strength of this hypoalgesic effect was further predicted by the change in cortisol and by fear of pain levels.ConclusionsOur findings indicate that the HPA axis – and not the autonomic – stress response specifically underlies this stress‐induced hypoalgesic effect, having important implications for clinical states with HPA axis dysfunctions.SignificanceThis experimental study shows that an acute stress induction – that combines physical and psychological stressors – increases heat pain thresholds, but not tolerance in healthy participants. Furthermore, the magnitude of this stress‐induced hypoalgesic effect is predicted by cortisol reactivity and fear of pain, revealing specific involvement of the HPA axis stress system and interactions with pain‐related psychosocial aspects.

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Section: Discussionsupporting

confidence: 93%

Fear of pain and cortisol reactivity predict the strength of stress‐induced hypoalgesia

Timmers

Kaas

Quaedflieg

et al. 2018

European Journal of Pain

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“…Our results indicate that the use of a CLT did not alter the level of anxiety or stress experienced by children in our study. The study was limited by the subjective measures we have employed and salivary cortisol levels may have been a beneficial objective measure of stress [11,40]. Wound healing, rates of infection and the need for skin grafting were similar in both groups, however, which supports our finding of similar levels of stress and anxiety experienced by the children in our study.…”

Section: Discussionsupporting

confidence: 77%

An assessment of early Child Life Therapy pain and anxiety management: A prospective randomised controlled trial

Hyland

D'Cruz

Harvey

et al. 2015

Burns

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“…Pain test: tests in which the participant feels pain (eg, hand dip tests in cold water and/or heat, or electrical stimuli) [ 37 , 39 - 43 , 45 , 50 , 53 , 54 , 70 , 73 , 81 , 98 ].…”

Section: Resultsmentioning

confidence: 99%

Understanding Monitoring Technologies for Adults With Pain: Systematic Literature Review

Rodríguez¹,

Herskovic²,

Gerea³

et al. 2017

J Med Internet Res

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BackgroundMonitoring of patients may decrease treatment costs and improve quality of care. Pain is the most common health problem that people seek help for in hospitals. Therefore, monitoring patients with pain may have significant impact in improving treatment. Several studies have studied factors affecting pain; however, no previous study has reviewed the contextual information that a monitoring system may capture to characterize a patient’s situation.ObjectiveThe objective of this study was to conduct a systematic review to (1) determine what types of technologies have been used to monitor adults with pain, and (2) construct a model of the context information that may be used to implement apps and devices aimed at monitoring adults with pain.MethodsA literature search (2005-2015) was conducted in electronic databases pertaining to medical and computer science literature (PubMed, Science Direct, ACM Digital Library, and IEEE Xplore) using a defined search string. Article selection was done through a process of removing duplicates, analyzing title and abstract, and then reviewing the full text of the article.ResultsIn the final analysis, 87 articles were included and 53 of them (61%) used technologies to collect contextual information. A total of 49 types of context information were found and a five-dimension (activity, identity, wellness, environment, physiological) model of context information to monitor adults with pain was proposed, expanding on a previous model. Most technological interfaces for pain monitoring were wearable, possibly because they can be used in more realistic contexts. Few studies focused on older adults, creating a relevant avenue of research on how to create devices for users that may have impaired cognitive skills or low digital literacy.ConclusionsThe design of monitoring devices and interfaces for adults with pain must deal with the challenge of selecting relevant contextual information to understand the user’s situation, and not overburdening or inconveniencing users with information requests. A model of contextual information may be used by researchers to choose possible contextual information that may be monitored during studies on adults with pain.

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Associations between fear-avoidance and endurance responses to pain and salivary cortisol in the context of experimental pain induction

Cited by 17 publications

References 13 publications

Fear of pain and cortisol reactivity predict the strength of stress‐induced hypoalgesia

Fear of pain and cortisol reactivity predict the strength of stress‐induced hypoalgesia

An assessment of early Child Life Therapy pain and anxiety management: A prospective randomised controlled trial

Understanding Monitoring Technologies for Adults With Pain: Systematic Literature Review

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