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Pain Research and Management
Volume 15, Issue 4, Pages 229-237
http://dx.doi.org/10.1155/2010/516176
Original Article

Attentional and Emotional Mechanisms of Pain Processing and Their Related Factors: A Structural Equations Approach

Claudia Huber,1,2 Miriam Kunz,1 Cordula Artelt,3 and Stefan Lautenbacher1

1Physiological Psychology, Otto-Friedrich University Bamberg, Bamberg, Germany
2Department of Anaesthesiology, Friedrich-Alexander University Hospital Erlangen, Erlangen, Germany
3Empirical Education Research, Otto-Friedrich University Bamberg, Bamberg, Germany

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND/OBJECTIVE: It is known that maladaptive attentional and emotional mechanisms of pain processing – as indicated by constructs such as pain hypervigilance, pain-related anxiety and pain catastrophizing – play an important role in the development and maintenance of chronic pain conditions. However, little is known to date about the potential risk factors for these forms of maladaptive processing. The aim of the present study was to shed more light on this issue. A very comprehensive set of predictor variables was examined in healthy pain-free subjects.

METHOD: Participants were 92 young and healthy subjects (mean [± SD] age 26.99±6.90 years; 47 men, 45 women). Maladaptive attentional and emotional mechanisms of pain processing were assessed by self-report measures of pain hypervigilance, pain-related anxiety and pain catastrophizing, as well as by a dot-probe task. The comprehensive set of predictor variables included measures of affective and bodily distress (depression, anxiety and somatization), experimental pain sensitivity, and cortisol reactivity. Directed relationships were estimated by using structural equation modelling.

RESULTS: Structural equation modelling revealed a significant path from affective and bodily distress to self-reported maladaptive attentional and emotional pain processing. In contrast, the paths from pain sensitivity and cortisol reactivity did not reach the level of significance.

CONCLUSION: These results support the position that anxiety and depression, as well as somatization, contribute to the aberrance of attentional and emotional mechanisms of pain processing. Surprisingly, the assumption of a close relationship between these maladaptive mechanisms of pain processing and pain sensitivity could not be confirmed.