Pain and Stress Processes: The Role of the Transactional Model of Stress and Mindfulness in Acute Pain

Master's ThesisChronic Pain has been found to be a critical factor contributing to disability and life dissatisfaction, comorbid mental disorders, and the socioeconomic cost among suffers and for society. From the biopsychosocial approach, pain experience has been understood as a complex phenomenon of objective and subjective experiences that account for sensory experiences as well as emotions and cognitions. Stress has been found to impact acute and chronic pain experiences. While there are several models of stress, the transactional model of stress serves a framework to explain the individual differences in stress responses. In particular, threat appraisals (primary appraisal) and pain catastrophizing (secondary appraisal) have been found to be associated with poorer pain-related outcomes. On the other hand, mindfulness has been found to be beneficial to stress responses and pain-related outcomes. Therefore, this study examined how cognitive stress appraisals, pain catastrophizing, and their interaction influence the pain experience in terms of pain ratings and pain tolerance as well as physiological reactivity of cardiovascular function and cortisol to an induced acute pain. The study also examined how trait mindfulness could influence these relations. Ninety-three undergraduate participants at the University of Michigan-Dearborn engaged in a cold pressor task and completed several self-reported measures such as the Stress Appraisal Measure (SAM), the Pain Catastrophizing Scale, the Mindfulness Attention Awareness Scale, and the Five Facet Mindfulness Questionnaire. Threat appraisals using the SAM were measured before and after the task. Also, blood pressure, heart rate, and cortisol reactivity data were collected as well as pain ratings, pain threshold, and pain tolerance. The results show that, in general, psychological predictor variables were associated with psychological outcome variables; however, psychological factors across the board did not predict pain tolerance or physiological reactivity. The study partially supported the transactional model of stress when considering the effects of psychological predictor variables of cognitive stress appraisals and pain catastrophizing over subjective pain ratings of an acute pain stimulus. It also supported that mindfulness could be beneficial to the cognitive stress appraisal processes and pain catastrophizing. The lack of general support for pain tolerance and physiological reactivity is considered within the context of social desirability and an allostatic model of stress examining differential contribution of cognitive and homeostatically driven physiological changes respectively. Future study to further investigate the associations between these psychological factors and physiological stress reactivity or pain tolerance may shed an additional light on our understanding in stress processes and pain-related outcomes. Keywords: Threat appraisals, Pain catastrophizing, Mindfulness, Stress, Pain experiencehttps://deepblue.lib.umich.edu/bitstream/2027.42/138014/1/Kim, Samsuk - Pain and Stress Processes. The Role of the Transactional Model of Stress and Mindfulness in Acute Pain.pdf13Description of Kim, Samsuk - Pain and Stress Processes. The Role of the Transactional Model of Stress and Mindfulness in Acute Pain.pdf : Master's Thesi

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The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. Supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the NIH (award K01‐AR‐064275; Principal Investigator, Dr. Kratz). The Michigan Institute for Clinical & Health Research (NIH award UL1‐TR‐002240) provided subject recruitment support through the UMHealthResearch.org website.Peer reviewedPublisher PD

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Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (award number K01AR064275; PI: Kratz). The Michigan Institute for Clinical & Health Research (MICHR: NIH award number UL1TR002240) provided subject recruitment support through the UMHealthResearch.org website. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Peer reviewedPostprin