Background & Aims
The relationship between pain and mental health is multifaceted and intricate. Both acute and chronic pain, as manifestations of inherently stressful experiences, are largely influenced by various mental health aspects. Previous studies have suggested an association between pain perception and psychological factors such as mood, distress, fatigue, and quality of life. Yet, these factors and their relationship to pain sensitivity have typically been investigated in isolation from one another, and with insufficiently powered sample sizes. Furthermore, the resulting findings lack coherence and exhibit contradictions. In this study, we aim to overcome these limitations and gain a better understanding of the complex inter-relationships between various psychological factors and thermal pain sensitivity.
Methods
We implemented a multivariate latent variable modeling approach in a sizable sample of adult participants (n = 257) to examine this interplay between unique psychological factors and thermal pain sensitivity. Through exploratory factor analysis of 10 mental health questionnaires, we identified three unique mental health factors related to distress, fatigue and bodily symptoms. Additionally, we established a measure of laboratory pain sensitivity using principal component analyses of three thermal pain thresholds (i.e., cold, heat and simultaneously cold and heat). We conducted regression analyses to examine the relationship between these variables. To quantify the strength of evidence, we calculated Bayes Factors for the regression models.
Results
Our results suggest no relationships between psychological factors and laboratory-based measures of thermal pain in individuals whose mental health ranged from no discernible symptoms to those with subclinical and clinical manifestations. We found no significant association between pain sensitivity and the factors distress (? = 0.66, SE = 0.64, t(256) = 1.03, p > 0.3), fatigue (? = -0.28, SE = 0.56, t(256) = -0.5, p > 0.62), and bodily symptoms (? = 0.41, SE = 0.51, t(256) = 0.8, p > 0.42). The overall model (F(3,256) = 0.85, p > 0.47) showed no relationship either. We validated these findings through the calculation of Bayes Factors, showing strong evidence favoring the null hypotheses (distress: BF01 = 0.29, fatigue: BF01 = 0.14, bodily symptoms: BF01 = 0.27, and multiple mental health factors: BF01 = 0.02).
Conclusions
In conclusion, this study found evidence disconfirming the notion that psychological factors, either individually or as a collective construct, could predict thermal pain thresholds in a sample of individuals with subclinical to clinical mental health symptoms. The subsequent Bayesian analysis offered further insights, confirming the absence of any correlation. However, this finding does not diminish the importance of understanding the intricate relationship between mental health and pain perception. We highlight the need for continued research to elucidate the underlying mechanisms linking psychological factors to pain sensitivity.
References
Boettger MK, Grossmann D, Bär K-J: Thresholds and Perception of Cold Pain, Heat Pain, and the Thermal Grill Illusion in Patients With Major Depressive Disorder. Psychosomatic Medicine 75:281–7, 2013.
Boettger MK, Schwier C, Bär K-J: Sad Mood Increases Pain Sensitivity Upon Thermal Grill Illusion Stimulation: Implications for Central Pain Processing. PAIN 152:123–30, 2011.
Dickens C, McGowan L, Dale S: Impact of Depression on Experimental Pain Perception: A Systematic Review of the Literature with Meta-Analysis: Psychosomatic Medicine 65:369–75, 2003.
Thompson T, Correll CU, Gallop K, Vancampfort D, Stubbs B: Is Pain Perception Altered in People With Depression? A Systematic Review and Meta-Analysis of Experimental Pain Research. The Journal of Pain 17:1257–72, 2016.
Presenting Author
Rebecca Astrid Böhme
Poster Authors
Rebecca Böhme
BSc
Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University
Lead Author
Leah Banellis
Ph.d.
Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University
Lead Author
Melina Vejlø
Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University
Lead Author
Micah G. Allen
Ph.d.
Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University
Lead Author
Topics
- Mechanisms: Psychosocial and Biopsychosocial