The Effect of State and Trait Anxiety on Pain-Pressure Threshold

Abstract

Background: The global burden of persistent pain is substantial, affecting up to 30% of the world's population. Despite growing awareness, challenges persist with accurate pain measurement, limiting research and clinical efforts. One method to assess pain perception is the Pain-Pressure Threshold (PPT), indicating the pressure at which pain is reported. Anxiety, comprising state and trait anxiety, has been suggested as a potential influencer of PPT, yet its precise impact remains uncertain. State anxiety is defined as a "transient state of arousal subjectively experienced as anxiety" Trait anxiety is “an individual's tendency to appraise situations as threatening, avoid anxiety-provoking situations, and demonstrate high baseline physiological arousal” Methods: Thirty-eight participants with no history of persistent pain or anxiety completed data collection, 19 men and 19 women, ages 22-32. Subjects completed the State-Trait Anxiety Inventory-5 (STAI-5) and underwent PPT testing at the upper trapezius and forearm extensors bilaterally, with results averaged to provide an extrapolation of global pressure tolerance. The same data was collected again 21 days later. Results: No correlation existed between anxiety and PPT. No significant correlation (p=.148) was observed in State anxiety scores between baseline and follow-up, while trait anxiety displayed a moderate relationship (r=.612, p<.001) between the initial and subsequent tests. These findings support the notion that state anxiety is more variable, contrasting with the presumed stability of trait anxiety. Pain-pressure threshold test-retest data revealed a moderate relationship (r=.542, p<.001), consistent with prior research on PPT test reliability. Discussion/Conclusion: This research is unique in that we assessed the relationship between anxiety and PPT in young, healthy participants. The principal finding is that pain-pressure thresholds were not shown to be influenced by either trait or state anxiety in our sample. The data also provided further information about the test-retest consistency of the STAI-5 and PPT measures. This research provides initial baseline data, against which findings in other populations can be compared. Future research should continue to aim to quantify psychosocial factors and their influence on pain experiences. Trial Registration: This study was registered on 21/09/2023 on ClinicalTrials.gov: # NCT06047704