Abstract
BACKGROUND: Depressive and pain symptoms often occur concurrently in patients with psychiatric disorders or somatic diseases, but the contribution of pre-existing dysfunctional cognitive schemata to pain perception remains unclear.OBJECTIVE: To investigate the relationship between depression-related attribution styles and perceived pain intensity (PPI) after controllable versus uncontrollable electrical skin stimulation in healthy male individuals.METHODS: Causal attributions for negative events were measured using the attribution style questionnaire (ASQ) on the dimensions internal versus external (INT), global versus specific (GLO) and stable versus unstable (STA) in 50 men (20 to 31 years of age). Additionally, symptoms of anxiety and depression (measured using the Depression Scale) as well as baseline helplessness were assessed. Participants were randomly assigned to receive self-administered (controllable) or experimenter-administered (uncontrollable) painful skin stimuli. PPI was assessed after stress exposure using a visual analogue scale (0 to 100). Relationships between PPI and depression-related cognitions were calculated using correlation and multiple regression analyses.RESULTS: Correlation analyses revealed a moderate correlation between PPI and ASQ-INT scores (r=0.46). Following uncontrollable stress exposure, significantly higher PPI ratings (P=0.001) and a higher correlation between PPI and ASQ-INT (r=0.70) were observed. Multiple regression analysis showed an independent influence of stressor controllability (ß=0.39; P=0.003) and ASQ-INT (ß=0.36; P=0.006) on PPI.DISCUSSION: These findings highlight the interaction of specific depression-related cognitions and stress controllability on pain intensity perception.CONCLUSIONS: The results of the present study may facilitate understanding of the cognitive aspects of pain intensity perception and improve psychological pain therapies focusing on attributions and controllability.