Sensitivity to Pain Traumatization: A Higher-Order Factor Underlying Pain-Related Anxiety, Pain Catastrophizing and Anxiety Sensitivity among Patients Scheduled for Major Surgery

Abstract

Twenty items from the ASI, the PASS-20 and the PCS loaded exclusively on one higher-order factor. The authors suggest the term 'sensitivity to pain traumatization' (SPT) for the underlying construct based in part on the strong, significant positive correlation between SPT scores and scores on the Post-traumatic Stress Disorder Checklist - Civilian Version. Finally, the total SPT score was significantly higher for patients with a history of pain than for those without a history of pain, both before surgery and one year after surgery. SPT describes the propensity to develop anxiety-related somatic, cognitive, emotional and behavioural responses to pain that resemble features of a traumatic stress reaction. Together, the results of the present study provide preliminary evidence for the construct validity of SPT.

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

“…These modest associations persisted when adjusted for sex, age, and number of medical comorbidities. Several psychologic factors, including anxiety or depression and catastrophizing, are associated with worse outcomes of surgical procedures including TKA [15,17,23,26,31,32]. Thus, the association we documented between painful body regions as determined using a body pain diagram and the MHI-5 and PCS scores suggests that the pain diagram may be useful in identifying patients at risk for a poor surgical outcome.…”

“…Pain diagrams have been associated with poor outcomes for numerous disorders [4,13,15,24,28]. Widespread pain, which can be documented with pain diagrams, has been associated with psychologic distress [24,28,33,34].…”

“…To assess the degree of pain catastrophizing, including patients' negative or exaggerated attitudes toward pain, we used the 13-item Pain Catastrophizing Scale (PCS) [30]. In addition to the continuous specification, we used a cutoff of 30 or greater as representing a high degree of pain catastrophizing [15,23,30]. The fiveitem Mental Health Index-5 (MHI-5) [3,25] was used as a measure of anxiety and depressive feelings.…”

“…Because widespread pain has been associated with poor outcome in various diseases [4,12,13,24,28], and because widespread pain is often clinically understood as a sign of psychologic distress [15,19,23,27,28,33,34], we posited that widespread pain, as documented on a pain diagram, would be associated with catastrophizing and depression and poor functional status.…”

Transitional Pain Medicine: novel pharmacological treatments for the management of moderate to severe postsurgical pain

“…[1] Opioid-naïve patients that have moderate to severe acute postoperative pain, [15] increased perioperative opioid use [16], preoperative negative affective states such as posttraumatic stress disorder, [17] depression, [18,19] anxiety, [7,20,21] and pain catastrophizing [22,23] are all candidates for our TPS given their increased risk to develop persistent pain and pain disability as a consequence of their surgical intervention.…”