Relation between Pain Catastrophizing and Reporting of Pain Threshold in Healthy Adults
Format of Original
Journal of Pain
Participants may not consistently report pain threshold under some testing conditions. The purpose of this study was to assess the possible relations of pain catastrophizing and fear of pain to failure to report pain threshold during assessment of conditioned pain modulation (CPM). Twenty young (21.9 ± 3.3 yrs, 10 men) and 19 older (72.0 ± 4.5 yrs, 10 men) adults participated. Pressure pain was assessed using a 1.5 kg weight mounted on a Lucite edge placed on the index finger for one minute. Participants were instructed to say “pain” when the pressure first changed to pain. Pressure pain thresholds were determined with the participant’s foot placed in neutral water (non-noxious control) and in noxious ice water. Fifteen participants [10 older (7 women); 5 young (3 women)] failed to report pain threshold with their foot immersed in the ice water compared with nine [6 older (1 woman); 3 young (1 woman)] in the neutral water. Five participants failed to report pain threshold in either condition (1 older woman, 2 older men, 2 young men). Adults who failed to report pain threshold in the ice water had higher pain catastrophizing (19.2 ± 10.5 vs 10.6 ± 7.6) and greater fear of pain (14.9 ± 5.6 vs 11.5 ± 4.5) than those who said “pain”. No group differences were found for the neutral water condition. Controlling for sex, the logistic regression model containing pain catastrophizing and fear of pain was significant only for the ice water condition [χ2 (3, N=39) = 11.815, p = 0.008] explaining 26.1-35.5% of the variance. Only pain catastrophizing made a unique contribution to the model (Odds Ratio 1.10, 95% C.I. 1.004–1.208). Our data suggest that individuals with higher pain catastrophizing are more likely to fail to report pain threshold for the test stimulus when assessing CPM.