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Testing the sequential model of pain processing in irritable bowel syndrome: a structural equation modeling analysis
Jeffrey M Lackner1, James Jaccard, Edward B Blanchard
1Behavioral Medicine Clinic, Department of Medicine, University at Buffalo School of Medicine and Biomedical Sciences, State University of New York, ECMC, 462 Grider Street, Buffalo, NY 14215, USA. lackner@buffalo.edu
European Journal of Pain (London, England)
|March 2, 2005
Summary
Irritable bowel syndrome (IBS) pain processing follows a sequential model, where sensation impacts unpleasantness, leading to suffering and behavior. However, pain sensation also directly affects behavior, independent of affect.
Area of Science:
- Neuroscience
- Gastroenterology
- Psychology
Background:
- Irritable bowel syndrome (IBS) is characterized by pain, a complex experience with sensory and emotional components.
- Price's pain processing model, with four sequential stages, is generally supported in healthy individuals and somatic pain patients but its applicability to IBS is unclear.
Purpose of the Study:
- To test the applicability of a four-stage sequential pain processing model in patients diagnosed with IBS.
- To examine the influence of contextual factors like age, gender, and trait anxiety on the pain processing stages in IBS.
Main Methods:
- Structural equation modeling (SEM) was employed.
- Data were collected from 168 individuals diagnosed with IBS according to Rome II criteria.
Main Results:
- Results supported a sequential pain processing order: sensation influenced unpleasantness, which then affected suffering and illness behaviors.
- Pain sensation also had direct effects on illness behaviors, independent of pain affect.
- Trait anxiety's effect on illness behavior was mediated by suffering; psychopathology directly impacted early pain stages; age and gender showed varied associations with different pain stages.
Conclusions:
- The findings generally support a four-stage pain processing model in IBS, with some modifications regarding direct pathways.
- Contextual factors like anxiety, psychopathology, age, and gender interact with pain processing stages in IBS patients.