Pain sensitivity is associated with general attitudes towards pain: Development and validation of a new instrument for pain research and clinical application

Abstract

Background: With regard to attitudes towards pain, many questionnaires have been developed. Although undoubtedly useful, they were specifically designed for the use in chronic pain and are less suitable for the assessment in the general population. The purpose of the present paper was to develop a measure for the assessment of general attitudes towards pain applicable in the general population, regardless of clinical condition, and to test its psychometric properties. Methods:We developed the General Attitudes Towards Pain Inventory and conducted two studies in order to provide psychometric data: In a general population sample (N = 362, study one), participants were asked to complete a questionnaire battery. To assess test-retest reliability, participants were contacted again after 4 weeks (retest sample: N = 101). For the evaluation of criterion validity (study two), a sample with sadomasochistic sexual preference (N = 68) was additionally recruited.Results: Statistical analyses revealed, overall, acceptable internal consistencies and test-retest reliabilities. A 10-factor model showed acceptable fit and was superior to alternative models. The inventory demonstrated convergent and divergent validity. In this context, we found pain sensitivity to be associated with pain attitudes. Finally, compared to the general population sample, individuals with sadomasochistic sexual preference showed significantly higher scores on fascination-pleasure and challenge subscales. Conclusions:In the present paper, we introduce a new and comprehensive instrument for pain research and provide evidence for its reliability and validity.In addition, we present new insights into how interindividual differences in pain sensitivity relate to pain attitudes. Statement of Significance:Acknowledging the lack of basic research on pain attitudes in the general population, we have developed and validated the first psychometric instrument to measure ten general attitudes towards pain. The

A matter of personality and point of view: How the interplay of reinforcement sensitivity and general attitudes towards pain impacts the responsivity to acute pain

“…Alongside the fact that BAS has been associated with sensation seeking (Smillie et al., 2006), it seems plausible that more adventurous individuals would be inclined to anticipate reward in the context of pain, an intense sensory experience. In support of this idea, capsaicin‐containing food liking (i.e., spicy meal liking) (Byrnes & Hayes, 2016) and sadomasochistic sexual preferences have previously been associated with sensation seeking (Schuerwegen et al., 2021), as have been the GATP fascination‐pleasure and challenge (Vetterlein et al., 2022). Moreover, considering that “the relief of pain is itself a pleasurable experience” (Bastian et al., 2014, p. 258) to seek after, the positive relationship between BAS and a positive inner tendency towards pain seems reasonable.…”

“…Participants' positive and negative attitudes towards physical pain were investigated by means of the General Attitudes Towards Pain Inventory (GATPI) (Vetterlein et al., 2022). The questionnaire comprises ten subscales, including being fascinated by pain or associating pain with lust and pleasure (fascination‐pleasure; FAS‐PLE), seeing pain as a challenge (challenge; CHA), as a valuable warning function (warning function; WAR), as something that is simply part of life and can be stoically accepted (acceptance and stoicism; ACS) and as something that leads to a secondary gain (secondary gain; SEC) in the sense of care and support by loved ones.…”

“…However, somewhat contrary to the burden of chronic pain, in acute (non‐clinical) pain, the perception of unpleasantness may vary depending on different contexts and individually associated rewards that might follow pain (Vecchio & De Pascalis, 2021). In other words, while one person might view pain as something strongly aversive (Vetterlein et al., 2022), another person might actively seek noxious stimuli for the anticipated reward of pain relief (vs. the mere escape from pain) or to reduce boredom (Vecchio & De Pascalis, 2021). Other examples of pain‐related reward include the release of opioids in response to physical exertion, the sense of achievement after having endured pain and the perceived sensation contrast (Bastian et al., 2014; Dunkley et al., 2020; Leknes & Tracey, 2008; Newmahr, 2010; Vetterlein et al., 2022).…”

“…In other words, while one person might view pain as something strongly aversive (Vetterlein et al., 2022), another person might actively seek noxious stimuli for the anticipated reward of pain relief (vs. the mere escape from pain) or to reduce boredom (Vecchio & De Pascalis, 2021). Other examples of pain‐related reward include the release of opioids in response to physical exertion, the sense of achievement after having endured pain and the perceived sensation contrast (Bastian et al., 2014; Dunkley et al., 2020; Leknes & Tracey, 2008; Newmahr, 2010; Vetterlein et al., 2022). These “inner tendencies towards pain and coping with pain, expressed by evaluations that might be of either positive or negative valence and might concern cognitive as well as affective and behavioural levels” (Vetterlein et al., 2022, p. 3), can be referred to as general attitudes towards pain (GATP), seen in the general population, independent of pain states (Vetterlein et al., 2022).…”

Development, validation and psychometric evaluation of the Chinese version of the biopsychosocial impact scale in orofacial pain patients

“…Following item selection and reliability analyses, an EFA was run in IBM SPSS Statistics 21 software and CFA were run in Mplus 8.4. version. Kaiser-Meyer-Olkin and Bartlett tests were used to determine the adequacy of the sampling of the EFA ( Vetterlein et al, 2022 ). Then, the latent factors of the BPIm-S were extracted via the maximum-likelihood EFA with varimax rotation.…”