Do difficulties in emotional processing predict procedure pain and shape the patient's colonoscopy experience?

Area of Science:

• Gastroenterology
• Psychology

Background:

• Pain and fear associated with colonoscopy negatively impact patient adherence to colorectal cancer screening.
• Maladaptive cognitions and exaggerated emotional responses contribute to patient fear and pain during colonoscopy.

Purpose of the Study:

• To investigate the predictive role of emotional processing difficulties in colonoscopy pain and pain catastrophizing.
• To understand the relationship between specific emotional processing deficits and patient-reported pain outcomes.

Main Methods:

• A prospective, observational study involving 123 patients undergoing colonoscopy.
• Assessment of emotional processing difficulties (e.g., emotion suppression, avoidance) and anxiety before the procedure.
• Objective and subjective measures of pain, including behavioral pain manifestations and pain catastrophizing scales post-procedure.

Main Results:

• Approximately 50% of patients exhibited pre-procedure anxiety.
• About one-third of patients experienced moderate pain during colonoscopy, despite sedation.
• Difficulties in emotion control, emotional experience, and avoiding emotional triggers correlated with increased pain and catastrophizing. Avoiding emotional triggers was a unique predictor of pain outcomes.

Conclusions:

• Emotional processing difficulties, especially avoidance of emotional triggers, are significant predictors of pain and catastrophizing during colonoscopy.
• Early identification of these psychological factors can inform personalized preparation strategies to mitigate patient distress and improve screening adherence.