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The Effect of Pain Resilience on Experimental Pain Experience Across Different Stimuli
Brett Ankawi1, P Maxwell Slepian, Lina Himawan
1From the VA Connecticut Healthcare System Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center for Innovation (Ankawi), West Haven, Connecticut; Ohio University (Ankawi, Slepian, Himawan, France), Athens, Ohio; Department of Psychology (Slepian), York University; and GoodHope Ehlers-Danlos Syndrome Clinic (Slepian), and Transitional Pain Service, Department of Anesthesia and Pain Medicine (Slepian), Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Objective:
Pain resilience, one's ability to maintain behavioral engagement and adaptively regulate cognitions and emotions despite intense or prolonged pain, has been shown to protect against negative pain-related outcomes in experimental settings. A weakness of this research, and much of experimental pain research in general, has been the lack of rationale behind the selection of noxious stimuli, which can activate different nociceptive fibers. The present study sought to determine if the relationship between pain resilience and pain ratings differed across stimuli based on the stimulated nociceptors.
Methods:
Healthy undergraduate students (N = 100; mean [SD] age = 19.4 [1.2] years; 60% female) completed the Pain Resilience Scale and provided continuous pain ratings during exposure to three different tasks, each selected based on their ability to stimulate specific combinations of nociceptive fibers: pinprick (Aδ fibers), cold water immersion (Aδ and C fibers), and ischemic tourniquet (C fibers).
Results:
Participants with high pain resilience reported lower pain ratings over time during cold water immersion than did those with low pain resilience (F(1, 39) = 8.526, p = .006); however, there was no relationship between pain resilience and pain ratings during either of the pinprick or ischemic tourniquet stimuli.
Conclusions:
This study provides further support for the use of multiple pain stimuli for pain assessment given their unique characteristics and concludes that outcome variables aside from pain ratings may provide additional insight into the role of resilience on pain adaptation.
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