A matter of personality and point of view: How the interplay of reinforcement sensitivity and general attitudes towards pain impacts the responsivity to acute pain

IF 3.5 2区医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-02-08 DOI:10.1002/ejp.2248

A. Vetterlein, S. A. Hogeterp, M. Monzel, M. Reuter

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Abstract

Background

The relatively stable individual differences reflected in Grey's revised reinforcement sensitivity theory (rRST), with foundations in neurophysiology and learning theory, appear particularly applicable to the study of pain. However, remarkably little research has been conducted in this area. In acute pain, activation of the behavioural approach system (BAS), the behavioural inhibition system (BIS) and the fight, flight, freezing system might depend on an individual's evaluation of pain. It was thus hypothesised that higher-order interactions of rRST traits and pain attitudes affect pain responsiveness.

Methods

To investigate relationships between rRST traits and pain attitudes and to identify patterns between clusters of participants, we conducted a study in which N = 275 healthy participants filled in Reuter and Montag's rRST-Q and the General Attitudes Towards Pain Inventory (GATPI). Experimental (pressure, electrical, thermal) and self-report data of pain responsiveness were collected in a subsample (N = 113).

Results

We found significant correlations between rRST-Q and GATPI subscales of up to r = 0.34. Two clusters were identified, significantly differing in rRST-Q and GATPI scores. Pain avoiders, characterized by high BIS, flight, freezing and negative pain attitudes, were found to be significantly more pain sensitive than pain approachers, characterized by high BAS, fight and positive pain attitudes. Moderate effects (d = 0.56 to d = 0.70) were demonstrated in subjective and objective measures and across pain modalities.

Conclusions

The present study expands the scientific knowledge on factors influencing pain responsiveness. Future research is needed to confirm implications for chronic pain prevention and therapy, particularly concerning pain avoiders.

Significance

We have identified two clusters of participants, pain avoiders and pain approachers, that not only present differential patterns of revised reinforcement theory traits and general attitudes towards pain but also differ in their pain responsiveness. Pain avoiders appeared more pain sensitive compared to pain approachers, both in objective and subjective measurements, with implications for the improvement of chronic pain prevention and therapy.

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个性和观点问题：强化敏感性和对疼痛的一般态度如何影响对急性疼痛的反应。

背景：格雷的强化敏感性修正理论（rRST）以神经生理学和学习理论为基础，反映了相对稳定的个体差异，似乎特别适用于疼痛研究。然而，这方面的研究却少得可怜。在急性疼痛中，行为接近系统（BAS）、行为抑制系统（BIS）和战斗、逃跑、冻结系统的激活可能取决于个体对疼痛的评估。因此，我们假设 rRST 特质和疼痛态度的高阶交互作用会影响疼痛反应性：为了研究 rRST 特质与疼痛态度之间的关系，并确定参与者群组之间的模式，我们进行了一项研究，让 N = 275 名健康参与者填写了 Reuter 和 Montag 的 rRST-Q 和疼痛总体态度量表 (GATPI)。在一个子样本（N = 113）中收集了疼痛反应性的实验（压力、电、热）和自我报告数据：结果：我们发现 rRST-Q 和 GATPI 子量表之间存在明显的相关性，r = 0.34。在 rRST-Q 和 GATPI 分数上有明显差异的两个群组被识别出来。以高 BIS、逃避、冻结和消极疼痛态度为特征的疼痛回避者的疼痛敏感度明显高于以高 BAS、对抗和积极疼痛态度为特征的疼痛接近者。在主观和客观测量以及各种疼痛模式中，均显示出中等程度的影响（d = 0.56 至 d = 0.70）：本研究拓展了有关疼痛反应性影响因素的科学知识。未来的研究需要确认对慢性疼痛预防和治疗的影响，尤其是对疼痛回避者的影响：我们发现了两类参与者，即疼痛回避者和疼痛接近者，他们不仅在修正强化理论特质和对疼痛的一般态度上表现出不同的模式，而且在疼痛反应性上也存在差异。与疼痛接近者相比，疼痛回避者在客观和主观测量方面对疼痛更为敏感，这对改善慢性疼痛的预防和治疗具有重要意义。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.