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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald


CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

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1877-8879
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Volume 17, Issue 1

Issues

Unpredictable pain timings lead to greater pain when people are highly intolerant of uncertainty

Clémence Bélanger
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Bernard Blais Morin
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Andréanne Brousseau
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Nicolas Gagné
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Anne Tremblay
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Kathya Daigle
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Philippe Goffaux
  • Department of Surgery, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
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/ Guillaume Léonard
  • Corresponding author
  • School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada J1H 5N4
  • Research Center on Aging, CIUSSS de l’Estrie-CHUS, Sherbroooke, QC, Canada J1H 4C4
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Published Online: 2017-10-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.09.013

Abstract

Background and purpose

Many psychological factors are known to influence pain perception. Among them, intolerance of uncertainty (IU) may play a key modulating role in situations where uncertainty prevails, especially uncertainty regarding the timing of painful events. The objective of this study was to explore the impact of individual differences in IUon pain perception during predictable and unpredictable stimulation timings. We hypothesized that people with high IU, as opposed to those with low IU, would perceive more pain when the timing of painful stimulations cannot be predicted, as compared to when they can.

Methods

Twenty (20) healthy adults, aged between 18 and 35 years old, were recruited. Painful sensations were provoked using transcutaneous electrical stimulations of the right sural nerve. By measuring IU (Intolerance of Uncertainty Scale) and subjective pain (verbal numerical rating scale), it was possible to test the relationship between IU and pain perception, by simulating predictable and unpredictable painful experiences. This was done through cued shock interval (CSI) blocks, with either variable timing or fixed timings (long or short time frame). Self-administered questionnaires were also used to measure pain hypervigilance, pain catastrophizing, state anxiety, and trait anxiety.

Results

Pearson correlations confirmed the presence of an association (r = 0.63) between IU and the change in pain intensity provoked by unpredictable stimulation timings. Importantly, this association was significant only for stimulations provided at long CSIs, indicating that higher IU scores predicted higher pain intensity scores when stimulation timings became unpredictable, and when the cued delay was long. No association was found between pain scores and other psychological variables.

Conclusions

Our results show that IU moderately correlates to the change in pain intensity provoked by unpredictable stimulation timings. High IU scores were associated with a worsening of the subjective pain experience, especially during long delays in an unpredictable situation. These observations suggest that IU could be considered as a psychological variable that is able to influence pain perception in certain situations.

Implications

Assessing and addressing IU could be an added value in pain-related therapy, especially in chronic pain.

Keywords: Pain; Intolerance of uncertainty; Anxiety; Hypervigilance; Experimental pain

References

  • [1]

    Simons LE, Elman I, Borsook D. Psychological processing in chronic pain: a neural systems approach. Neurosci Biobehav Rev 2014;39:61–78.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [2]

    Knotek P, Knotkova H. Psychological processes in chronic pain: a structural model. J Pain Manag 2008;1:295–305.Google Scholar

  • [3]

    Linton S. Understanding pain for better clinical practice: a psychological perspective. Elsevier Health Sciences; 2005.Google Scholar

  • [4]

    Hadjistavropoulos T, Hadjistavropoulos T, Psych R, Craig KD. Pain: psychological perspectives. Psychology Press; 2004.Google Scholar

  • [5]

    Spielberger C, Gorsuch R, Lushene R. Manuel for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.Google Scholar

  • [6]

    Hollins M, Harper D, Gallagher S, Owings EW, Lim PF, Miller V, Siddiqi MQ, Maixner W. Perceived intensity and unpleasantness of cutaneous and auditory stimuli: an evaluation of the generalized hypervigilance hypothesis. Pain 2009;141:215–21.Web of SciencePubMedCrossrefGoogle Scholar

  • [7]

    Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefeb-vre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain 2001;17:52–64.CrossrefPubMedGoogle Scholar

  • [8]

    McDermid AJ, Rollman GB, McCain GA. Generalized hypervigilance in fibromyalgia: evidence of perceptual amplification. Pain 1996;66:133–44.PubMedCrossrefGoogle Scholar

  • [9]

    Ruscheweyh R, Albers C, Kreusch A, Sommer J, Marziniak M. The effect of catas-trophizing self-statements on pain perception and the nociceptive flexor reflex (Rlll reflex). Clin J Pain 2013;29:725–32.CrossrefGoogle Scholar

  • [10]

    Dugas M, Buhr K, Ladouceur R. The role of intolerance of uncertainty in etiolody and maintenance.Generalized anxiety disorder: advances in research and practice. New York: Guilford Press; 2004.Google Scholar

  • [11]

    Nelson BD, Shankman SA. Does intolerance of uncertainty predict anticipatory startle responses to uncertain threat? lnt J Psychophysiol 2011;81: 107–15.CrossrefGoogle Scholar

  • [12]

    Gole M, Schafer A, Schienle A. Event-related potentials during exposure to aversion and its anticipation: the moderating effect of intolerance of uncertainty. Neurosci Lett 2012;507:112–7.Web of ScienceCrossrefPubMedGoogle Scholar

  • [13]

    Wiech K, Ploner M, Tracey L. Neurocognitive aspects of pain perception. Trends Cogn Sci 2008;12:306–13.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [14]

    Carlsson K, Andersson J, Petrovic P, Petersson KM, Ohman A, lngvar M. Predictability modulates the affective and sensory-discriminative neural processing of pain. Neuroimage 2006;32:1804–14.CrossrefPubMedGoogle Scholar

  • [15]

    Oka S, Chapman CR, Kim B, Shimizu O, Noma N, Takeichi O, Lmamura Y, Oi Y. Predictabilityof painful stimulation modulates subjective and physiological responses. J Pain 2010;11:239–46.PubMedCrossrefGoogle Scholar

  • [16]

    Meulders A, Vansteenwegen D, Vlaeyen JW. Women, but not men, report increasingly more pain during repeated (un)predictable painful electro-cutaneous stimulation: evidence for mediation by fear of pain. Pain 2012;153:1030–41.CrossrefGoogle Scholar

  • [17]

    Lin CS, Hsieh JC, Yeh TC, Niddam DM. Predictability-mediated pain modulation in context of multiple cues: an event-related fMRl study. Neuropsychologia 2014;64:85–91.CrossrefGoogle Scholar

  • [18]

    Dworkin RH, Turk DC, Farrar JT, HaythornthwaiteJA Jensen MP, Katz NP, Kerns RD, Stucki G, Allen RR, Bellamy N, Carr DB, Chandler J, Cowan P, Dionne R, Galer BS, Hertz S, Jadad AR, Kramer LD, Manning DC, Martin S, McCormick CG, McDermott MP, McGrath P, Quessy S, Rappaport BA, Robbins W, Robinson JP, Rothman M, Royal MA, Simon L, Stauffer JW, Stein W, Tollett J, Wernicke J, Witter J. l MMPACT. Core outcome measures for chronic pain clinical trials: lMMPACT recommendations.Pain 2005;113:9–19.CrossrefPubMedGoogle Scholar

  • [19]

    Freeston MH, Rheaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Pers lndiv Diff 1994;17:791–802.CrossrefGoogle Scholar

  • [20]

    Buhr K, Dugas MJ. The lntolerance of Uncertainty Scale: psychometric properties of the Englishversion. Behav Res Ther 2002;40:931–45.PubMedCrossrefGoogle Scholar

  • [21]

    Bergeron J, Landry M, Belanger D. The development and validation of a French form of the state-trait anxiety inventory. Cross-cultural anxiety. Washington (DC): Hemisphere Publishing; 1976. p. 41–50.Google Scholar

  • [22]

    French D, Noel M, Vigneau F, French J, Cyr C, Evans R. L’échelle de dramatisation face à la douleur PCS-CF: adaptation canadienne en langue française de l’echelle pain catastrophizing scale. Can J Behav Sci 2005;37: 181–92.CrossrefGoogle Scholar

  • [23]

    Granot M, Weissman-Fogel L, Crispel Y, Pud D, Granovsky Y, Sprecher E, Yarnitsky D. Determinants of endogenous analgesia magnitude in a diffuse noxious inhibitory control (DNlC) paradigm: do conditioning stimulus painfulness, gender and personality variables matter? Pain 2008;136: 142–9.CrossrefGoogle Scholar

  • [24]

    French DJ, France CR, France JL, Arnott LF. The influence of acute anxiety on assessment of nociceptive flexion reflex thresholds in healthy young adults. Pain 2005;114:358–63.CrossrefPubMedGoogle Scholar

  • [25]

    Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995;7:524.Google Scholar

  • [26]

    Roelofs J, Peters ML, McCracken L, Vlaeyen JW. Thepainvigilanceandawareness questionnaire (PVAQ): further psychometric evaluation in fibromyalgia and otherchronic pain syndromes. Pain 2003;101:299–306.PubMedCrossrefGoogle Scholar

  • [27]

    McCracken LM. “Attention” to pain in persons with chronic pain: a behavioral approach. BehavTher 1997;28:271–84.Google Scholar

  • [28]

    Story GW, Vlaev L, Seymour B, Winston JS, Darzi A, Dolan RJ. Dread and the disvalue of future pain. PLoS Comput Biol 2013;9:e1003335.Web of ScienceCrossrefPubMedGoogle Scholar

  • [29]

    Hauck M, Lorenz J, Zimmermann R, Debener S, Scharein E, Engel AK. Duration of the cue-to-pain delay increases pain intensity: a combined EEG and MEG study. Exp Brain Res 2007;180:205–15.Web of ScienceCrossrefPubMedGoogle Scholar

  • [30]

    Berns GS, Chappelow J, Cekic M, Zink CF, Pagnoni G, Martin-Skurski ME. Neurobiological substrates of dread. Science 2006;312:754–8.CrossrefPubMedGoogle Scholar

  • [31]

    Rhudy JL, Williams AE, McCabe KM, Rambo PL, Russell JL. Emotional modulation ofspinal nociception and pain: the impact of predictable noxious stimulation. Pain 2006;126:221–33.file-76CrossrefGoogle Scholar

About the article

Research Center on Aging, CIUSSS de l’Estrie-CHUS, 1036, rue Belvédère Sud, Sherbroooke, QC, Canada J1H 4C4


Received: 2017-07-20

Revised: 2017-09-13

Accepted: 2017-09-14

Published Online: 2017-10-01

Published in Print: 2017-10-01


Ethical issues: All participants provided written, informed consent, and the research protocol was approved by the ethics committee of the Centre Hospitalier Universitaire de Sherbrooke (CHUS).

Conflict of interest: The authors have no conflicts of interest to disclose.

Financial support: P. Goffaux and G. Léonard are supported by the Fonds de recherche Santé (FRQS, Québec, Canada) and by the Natural Sciences and Engineering Research Council (NSERC, Canada).


Citation Information: Scandinavian Journal of Pain, Volume 17, Issue 1, Pages 367–372, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.09.013.

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