Somatic Awareness and Tender Points in a Community Sample

Abstract

Somatic awareness (SA) refers to heightened sensitivity to a variety of physical sensations and symptoms. Few attempts have been made to dissociate the relationship of SA and affective symptoms with pain outcomes. We used a validated measure of mood and anxiety symptoms that includes questions related to SA to predict the number of tender points found on physical examination in a large cross-sectional community sample (the Midlife in the United States [MIDUS] Biomarker study). General distress, positive affect, and SA, which were all significantly associated with tender point number in bivariate analyses, were used as predictors of the number of tender points in a multivariate negative binomial regression model. In this model a greater number of tender points was associated with higher levels of SA (p = .02) but not general distress (p = .13) or positive affect (p = .50). Follow-up mediation analyses indicated that the relationship between general distress and tender points was partially mediated by levels of SA. Our primary finding is that SA is strongly related to the number of tender points in a community sample. Mechanisms linking SA to the spatial distribution of pain sensitivity should be investigated further. Perspective This article presents an analysis of three overlapping psychological constructs and their relationship to widespread pain sensitivity on palpation. The findings suggest that somatic awareness is most strongly related to the spatial distribution of pain sensitivity and that further assessing it may improve our understanding of the relationship between psychological factors and pain.

Adverse Childhood Experiences and Symptoms of Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study

“…Concepts like pain catastrophizing and increased levels of perceived stress may be indicative of a stress reactive phenotype in chronic pain [29]. Similarly, the burden of somatic symptoms has been previously linked to greater pain sensitivity independently of depressive and anxious symptoms [30]. However, the vast majority of studies have considered the relationship between ACEs and chronic pain in a relatively static manner, and have not considered the broad range of potential associations between psychological and physical constructs and ACEs in the context of chronic pelvic pain.…”