M Studer1, J Stewart2, N Egloff2, E Zürcher2, R von Känel2,3, J Brodbeck4, M Grosse Holtforth2,4. 1. Kompetenzbereich für Psychosomatische Medizin, Univ.-Klinik für Allgemeine Innere Medizin, Inselspital Bern, Bern, Schweiz. martina.studer2@insel.ch. 2. Kompetenzbereich für Psychosomatische Medizin, Univ.-Klinik für Allgemeine Innere Medizin, Inselspital Bern, Bern, Schweiz. 3. Departement für Psychosomatische Medizin, Klinik Barmelweid, Barmelweid, Schweiz. 4. Institut für Psychologie, Universität Bern, Bern, Schweiz.
Abstract
BACKGROUND: Increased pain sensitivity is characteristic for patients with chronic pain disorder with somatic and psychological factors (F45.41). Persistent stress can induce, sustain, and intensify pain sensitivity, thereby modulating pain perception. In this context, it would be favorable to investigate which psychosocial stressors are empirically linked to pain sensitivity. OBJECTIVES: The aim of this study was to examine the relationship between psychosocial stressors and pain sensitivity in a naturalistic sample of patients with chronic pain disorder with somatic and psychological factors (F45.41). MATERIALS AND METHODS: We assessed 166 patients with chronic pain disorder with somatic and psychological factors (F45.41) at entry into an inpatient pain clinic. Pain sensitivity was measured with a pain provocation test (Algopeg) at the middle finger and earlobe. Stressors assessed were exposure to war experiences, adverse childhood experiences, illness-related inability to work, relationship problems, and potentially life-threatening accidents. Correlation analyses and structural equation modeling were used to examine which stressors showed the strongest prediction of pain sensitivity. RESULTS: Patients exhibited generally heightened pain sensitivity. Both exposure to war and illness-related inability to work showed significant bivariate correlations with pain sensitivity. In addition to age, they also predicted a further increase in pain sensitivity in the structural equation model. CONCLUSIONS: Bearing in mind the limitations of this cross-sectional study, these findings may contribute to a better understanding of the link between psychosocial stressors and pain sensitivity.
BACKGROUND: Increased pain sensitivity is characteristic for patients with chronic pain disorder with somatic and psychological factors (F45.41). Persistent stress can induce, sustain, and intensify pain sensitivity, thereby modulating pain perception. In this context, it would be favorable to investigate which psychosocial stressors are empirically linked to pain sensitivity. OBJECTIVES: The aim of this study was to examine the relationship between psychosocial stressors and pain sensitivity in a naturalistic sample of patients with chronic pain disorder with somatic and psychological factors (F45.41). MATERIALS AND METHODS: We assessed 166 patients with chronic pain disorder with somatic and psychological factors (F45.41) at entry into an inpatient pain clinic. Pain sensitivity was measured with a pain provocation test (Algopeg) at the middle finger and earlobe. Stressors assessed were exposure to war experiences, adverse childhood experiences, illness-related inability to work, relationship problems, and potentially life-threatening accidents. Correlation analyses and structural equation modeling were used to examine which stressors showed the strongest prediction of pain sensitivity. RESULTS:Patients exhibited generally heightened pain sensitivity. Both exposure to war and illness-related inability to work showed significant bivariate correlations with pain sensitivity. In addition to age, they also predicted a further increase in pain sensitivity in the structural equation model. CONCLUSIONS: Bearing in mind the limitations of this cross-sectional study, these findings may contribute to a better understanding of the link between psychosocial stressors and pain sensitivity.
Entities:
Keywords:
Algopeg; Chronic pain disorder with somatic and psychological factors (F45.41); Pain sensitivity; Psychosocial stressors; Structural equation model
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