Pain-related anxiety influences pain perception differently in men and women: A quantitative sensory test across thermal pain modalities

Abstract

a b s t r a c tThe sexes differ with respect to perception of experimental pain. Anxiety influences pain perception more in men than in women; however, there lacks research exploring which anxiety constructs influence pain perception differentially between men and women. Furthermore, research examining whether depression is associated with pain perception differently between the sexes remains scant. The present investigation was designed to examine how trait anxiety, pain-related anxiety constructs (ie, fear of pain, pain-related anxiety, anxiety sensitivity), and depression are associated with pain perception between the sexes. A total of 95 nonclinical participants (55% women) completed measures assessing the constructs of interest and participated in quantitative sensory testing using heat and cold stimuli administered by a Medoc Pathway Pain and Sensory Evaluation System. The findings suggest that pain-related anxiety constructs, but not trait anxiety, are associated with pain perception. Furthermore, these constructs are associated with pain intensity ratings in men and pain tolerance levels in women. This contrasts with previous research suggesting that anxiety influences pain perception mostly or uniquely in men. Depression was not systematically associated with pain perception in either sex. Systematic relationships were not identified that allow conclusions regarding how fear of pain, pain-related anxiety, and anxiety sensitivity may contribute to pain perception differentially in men and women; however, anxiety sensitivity was associated with increased pain tolerance, a novel finding needing further examination. The results provide directions for future research and clinical endeavors and support that fear and anxiety are important features associated with hyperalgesia in both men and women.

Longitudinal Associations Between Depression, Anxiety, Pain, and Pain-Related Disability in Chronic Pain Patients

“…Correspondingly, from the neurobiological perspective, depression, anxiety, and pain share common cortical regions, neurobiological networks, and neurochemical compounds such as serotonin and neuroadrenalin (71)(72)(73). Elevated depression or anxiety was found to cause changes in these common networks effecting the modulation of pain and may increase sensitivity to pain (74,75). In addition, the physiological reaction to anxiety may cause a reduced threshold to pain (76,77).…”

The effects of emotion regulation strategies on the pain experience

“…We do note, however, that the values for threshold and tolerance obtained in this study were highly comparable with values obtained in other studies involving the use of the thermal pain stimulator with college and university students. 23,76 In addition to methodological differences in estimating threshold and tolerance, noncomprehensive or otherwise limited approaches to quantification (eg, assessment of suppression using a single question that has not been validated 66 ) of selfreported ER strategies were utilized in some previous research. Such limited quantification could have also affected the results.…”

Relations between pain-related anxiety, tobacco dependence, and barriers to quitting among a community-based sample of daily smokers

“…Second, the sample was comprised of participants who were willing to undertake a self-guided quit attempt, which may limit the generalizability of these findings. Third, although we accounted for relevant covariates, there may be other important factors (such as lifetime psychopathology or comorbid health disorders) that may increase the anxiety-eliciting properties of pain (Staats, Staats, & Hekmat, 2001; Thibodeau, Welch, Katz, & Asmundson, 2013). Fourth, only a single asessment of pain was utilized and we did not asess other factors (e.g., pain location) that may be related to both psychological functioning and variations in the pain experience (Miro, Gertz, Carter, & Jensen, 2014).…”