13 research outputs found

    The Influence of Pain Intensity and Executive Functioning on Facial Pain Expression

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    Facial pain expressions are frequently used to assess pain in populations that cannot verbally express their suffering. The present study aimed to investigate the usefulness of facial expressions as an assessment tool and the influence of executive functioning on facial pain expression. Pain ratings to mechanical nociceptive stimuli were obtained from 57 healthy elderly, facial pain expressions were filmed and coded, working memory and cognitive inhibition were assessed. Results showed a positive correlation between stimulus intensity and pain expressions which was moderated by cognitive inhibition. Pain intensity has a stronger effect on facial pain expression at low levels of inhibition

    The Influence of Executive Functioning on Facial and Subjective Pain Responses in Older Adults

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    Cognitive decline is known to reduce reliability of subjective pain reports. Although facial expressions of pain are generally considered to be less affected by this decline, empirical support for this assumption is sparse. The present study therefore examined how cognitive functioning relates to facial expressions of pain and whether cognition acts as a moderator between nociceptive intensity and facial reactivity. Facial and subjective responses of 51 elderly participants to mechanical stimulation at three intensities levels (50 kPa, 200 kPa, and 400 kPa) were assessed. Moreover, participants completed a neuropsychological examination of executive functioning (planning, cognitive inhibition, and working memory), episodic memory, and psychomotor speed. The results showed that executive functioning has a unique relationship with facial reactivity at low pain intensity levels (200 kPa). Moreover, cognitive inhibition (but not other executive functions) moderated the effect of pressure intensity on facial pain expressions, suggesting that the relationship between pressure intensity and facial reactivity was less pronounced in participants with high levels of cognitive inhibition. A similar interaction effect was found for cognitive inhibition and subjective pain report. Consequently, caution is needed when interpreting facial (as well as subjective) pain responses in individuals with a high level of cognitive inhibition

    Der Teufelskreis aus Schmerz, Angst und Bewegungsvermeidung: Ursachen und mögliche Auswege

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    Menschen mit chronischen Schmerzen haben mitunter Angst vor bestimmten Bewegungen. Sie vermeiden entsprechende Aktivitäten, bauen körperlich ab und leiden schlimmstenfalls unter noch stärkeren Schmerzen und Depressionen. Die Ursache für ihre ‚Kinesiophobie‘ liegt in bewegungsassoziierten Negativerfahrungen, im sozialen Umfeld und auch in der unbeabsichtigten Fehlkommunikation oder etwaigen Verunsicherung von Therapeuten. Die Expositionstherapie sowie das Graded-Activity-Konzept helfen, um den Teufelskreis des Angst-Vermeidungs-Modells zu durchbrechen.status: publishe

    The Influence of Executive Functioning on Facial and Subjective Pain Responses in Older Adults

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    Cognitive decline is known to reduce reliability of subjective pain reports. Although facial expressions of pain are generally considered to be less affected by this decline, empirical support for this assumption is sparse.The present study therefore examined how cognitive functioning relates to facial expressions of pain and whether cognition acts as a moderator between nociceptive intensity and facial reactivity. Facial and subjective responses of 51 elderly participants tomechanical stimulation at three intensities levels (50 kPa, 200 kPa, and 400 kPa) were assessed. Moreover, participants completed a neuropsychological examination of executive functioning (planning, cognitive inhibition, and working memory), episodic memory, and psychomotor speed. The results showed that executive functioning has a unique relationship with facial reactivity at low pain intensity levels (200 kPa). Moreover, cognitive inhibition (but not other executive functions) moderated the effect of pressure intensity on facial pain expressions, suggesting that the relationship between pressure intensity and facial reactivity was less pronounced in participants with high levels of cognitive inhibition. A similar interaction effect was found for cognitive inhibition and subjective pain report. Consequently, caution is needed when interpreting facial (as well as subjective) pain responses in individuals with a high level of cognitive inhibition.status: publishe

    Trial and Error (-Related Negativity):An Odyssey of Integrating Different Experimental Paradigms

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    Pain can be considered as a signal of “bodily error”: Errors – discrepancies between the actual and optimal/targeted state – can put organisms at danger and activate behavioral defensive systems. If the error relates to the body, pain is the warning signal that motivates protective action such as avoidance behavior to safeguard our body’s integrity. Hence, pain shares the functionality of errors. On the neural level, an important error processing component is the error-related negativity (ERN), a negative deflection in the electroencephalographic (EEG) signal generated primarily in the anterior cingulate cortex within 100 ms a er error commission. Despite compelling evidence that the ERN plays an important role in the development of various psychopathologies and is implicated in learning and adjustment of behavior, its relation to pain-related avoidance has not yet been examined. Based on findings from anxiety research, it seems conceivable that individuals with elevated ERN amplitudes are more prone to engage in pain-related avoidance behavior, which may, under certain conditions, be a risk factor for developing chronic pain. Consequently, this newline of research promises to contribute to our understanding of human pain. As in most novel research areas, a first crucial step for integrating the scientific fields of ERN and pain is developing a paradigm suited to address the needs from both fields. The present manuscript presents the development and piloting of an experimental task measuring both ERN and avoidance behavior in response to painful mistakes, as well as the challenges encountered herein. A total of 12 participants underwent one of six different task versions. We describe in detail each of these versions, including their results, shortcomings, our solutions, and subsequent steps. Finally,we provide some advice for researchers aiming at developing novel paradigms

    General versus pain‐specific cognitions: Pain catastrophizing but not optimism influences conditioned pain modulation

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    Background Previous studies found evidence that dispositional optimism is related to lower pain sensitivity. Recent findings suggest that temporarily increasing optimism by means of imagining a positive future may also have pain‐alleviating effects. Objectives The present experiment was designed to investigate conditioned pain modulation (CPM) as a potential underlying mechanism of this pain‐alleviating effect of induced optimism. Methods For this purpose, 45 healthy participants were randomized into an optimistic or neutral imagery condition. Additionally, participants completed questionnaires on dispositional optimism, pain catastrophizing and pain expectations. CPM was assessed by delivering a series of five heat pain stimuli on the non‐dominant hand before and during immersion of the dominant hand in water of 5C° for 70 seconds. Results A clear CPM effect was found, i.e. heat pain reports were lower during simultaneous cold water stimulation. Although the optimism manipulation successfully increased optimism, it did not affect pain ratings or CPM. Post‐hoc analyses indicated that dispositional optimism was not associated with the magnitude of CPM, but pain catastrophizing and pain expectations did significantly correlate with the CPM effect. Conclusion Pain‐specific but not general cognitions appear to influence endogenous pain modulation.status: publishe

    Modulating pain thresholds through classical conditioning

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    Background Classical conditioning has frequently been shown to be capable of evoking fear of pain and avoidance behavior in the context of chronic pain. However, whether pain itself can be conditioned has rarely been investigated and remains a matter of debate. Therefore, the present study investigated whether pain threshold ratings can be modified by the presence of conditioned non-nociceptive sensory stimuli in healthy participant. Methods In 51 healthy volunteers, pain threshold to electrocutaneous stimuli was determined prior to participation in a simultaneous conditioning paradigm. Participants underwent an acquisition phase in which one non-painful vibrotactile stimulus (CS+) was repeatedly paired with a painful electrocutaneous stimulus, whereas a second vibrotactile stimulus of the same quality and intensity (CS−) was paired with a non-painful electrocutaneous stimulus. Stimulation was provided on the lower back with close proximity between the conditioned stimulus and the unconditioned stimulus. In the test phase, electrocutaneous stimuli at the individually-set threshold intensity were simultaneously delivered together with either a CS+ or CS−. Pain intensity ratings were obtained after each trial; expectancy ratings were obtained after each block. The primary outcome was the percentage of test stimuli that were rated as painful. Results Test stimuli were more likely to be rated as painful when they were paired with the CS+ than when they were paired with the CS−. This effect was not influenced by contingency awareness, nor by expectancies or mood states. Discussion The findings support the notion that the judgement of an event being painful or non-painful can be influenced by classical conditioning and corroborate the possible role of associative learning in the development and maintenance of chronic pain.status: Published onlin

    Pain-related beliefs are associated with arm function in persons with frozen shoulder

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    Background: Frozen shoulder is a painful glenohumeral joint condition. Pain-related beliefs are recognized drivers of function in musculoskeletal conditions. This cross-sectional study investigates associations between pain-related beliefs and arm function in frozen shoulder. Methods: Pain intensity, arm function (Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH)), pain catastrophizing (Pain Catastrophizing Scale (PCS)), pain-related fear (Tampa Scale for Kinesiophobia (TSK-11)) and pain self-efficacy (Pain Self-Efficacy Questionnaire (PSEQ)) were administered in 85 persons with frozen shoulder. Correlation analyses assessed associations between pain-related beliefs and arm function. Regression analysis calculated the explained variance in arm function by pain-related beliefs. Results: Pain-related fear, pain catastrophizing and pain self-efficacy were significantly associated with arm function (r¼0.51; r¼0.45 and r¼ 0.69, all p<.0001, respectively). Thirty-one percent of variance in arm function was explained by control variables, with pain intensity being the only significant one. After adding TSK-11, PCS and PSEQ scores to the model, 26% extra variance in arm function was explained, with significant contributions of pain intensity, pain-related fear and pain self-efficacy (R2¼0.57). Conclusions: Attention should be paid towards the negative effect of pain-related fear on outcomes in frozen shoulder and towards building one’s pain self-efficacy given its protective value in pain management.status: Published onlin
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