Pain Catastrophizing is Associated with Dental Pain in a Stressful Context

Abstract

A supplemental appendix to this article is published electronically only at http://jdr.sagepub.com/supplemental. ABSTRACT Pain is associated with anxiety in a dental setting. It has remained unclear how cognitive-affective factors modulate pain and anxiety in a stressful context, such as receiving dental procedures. We hypothesized that both the situational factor (unpredictability about painful stimuli) and the trait factor (pain catastrophizing, i.e., the tendency to interpret pain in negative orientation) account for dental pain. Fifteen healthy participants were recruited to perform an associative learning task. They were asked to learn the pairing between visual cues and the intensity of incoming painful stimuli delivered at the right upper central incisor. Brain activation associated with pain was recorded by functional magnetic resonance imaging (fMRI). The participants reported increased anxiety and pain in the stressful context, where stimuli intensity was not predicted by the preceding cue. The score of the Pain Catastrophizing Scale was positively correlated with the increased pain modulated by unpredictability. Brain activation at the right posterior hippocampus, a region critically related to associative learning of aversive stimuli and context, was correlated with the individual catastrophizing level. Our findings suggest that both the situational factor (unpredictability) and the trait factor (catastrophizing) influence dental pain, highlighting the role of cognitive-affective factors in pain control of dental patients.

Brain Areas Involved in Anticipation of Clinically Relevant Pain in Low Back Pain Populations With High Levels of Pain Behavior

“…This augmentation of the interruptive function of pain on memory by pain catastrophizing agrees with other findings 60,57 and may reflect particular problems in disengaging from pain in NSLBP populations with high levels of pain behaviour. 33,59,60 Contrary to our predictions, we found greater activity in cortex -pMCC -using the nomenclature described by 63 ) is involved in visuospatial orientation that is mediated through its extensive parietal lobe connections (for a review see 65 ) and very early orienting responses to noxious stimuli through caudal cingulate motor areas 9,38,76 and spinal cord and motor cortex projections. 15 The dorsal part of PCC (dPCC) may share some functions with pMCC and be involved in orienting the body towards innocuous and noxious somatosensory stimuli and assessment of self-relevant sensation.…”

Investigation of factors that influence pain experienced and the use of pain medication following periodontal surgery

“…Finding that anticipated pain and actual pain are positively correlated and that individuals who anticipate more pain tend to experience more pain highlights the psychological component of pain. Several studies that have examined the psychological component of acute pain have used the Pain Catastrophizing Scale (PCS) to measure an individual's affect towards their pain (Lin, Niddam, Hsu, & Hsieh, ; Pallegama, Ariyasinghe, Perera, & Treede, ; Quartana, Campbell, & Edwards, ). Pain catastrophizing is measured based on three main pillars: rumination, magnification and helplessness; these pillars evaluate the degree to which patients dwell on the pain they are experiencing or are about to experience, think that the pain will get worse, and how they feel like they can cope with the pain (Quartana et al., ).…”

“…Pain catastrophizing is measured based on three main pillars: rumination, magnification and helplessness; these pillars evaluate the degree to which patients dwell on the pain they are experiencing or are about to experience, think that the pain will get worse, and how they feel like they can cope with the pain (Quartana et al., ). In a setting where pain intensity was unpredictable, PCS score was correlated with pain rating, but not when pain intensity was predictable (Lin et al., ). Therefore, the unpredictability of the pain and not the pain intensity itself was what caused the difference in pain rating between the two conditions; supporting the assertion that pain rating is not merely physiological, but that there is a psychological component as well.…”

A study on the prevalence of dental anxiety, pain perception, and their interrelationship in Chinese patients with oral implant surgery

“…Approximately two in three patients undergoing dental implant surgeries experience moderate or high preoperative DA . Accumulating evidence has revealed that DA is associated with pain perception and patient satisfaction related to dental procedures . Different surgical procedures may cause anxiety for different reasons .…”

“…2 Accumulating evidence has revealed that DA is associated with pain perception and patient satisfaction related to dental procedures. [3][4][5][6] Different surgical procedures may cause anxiety for different reasons. 2 Patients may not be able to cooperate with dentists when they experience anxiety during dental treatment, which may increase the amount of time needed and the level of difficulty in performing procedures, thereby causing unsatisfactory treatment results.…”