Scientists have long wondered why some individuals are more sensitive to pain than others. While individual differences in pain have traditionally been discounted due to neuroticism, research has shown that individuals who are more sensitive to pain demonstrate real biological differences in pain perception (Coghill, McHaffie & Yen, 2003). However, individual differences in pain sensitivity remain under-explored in research and clinical settings that can provide further insights into clinical disorders such as addiction. The current research review is interested in examining the link between pain sensitivity and alcohol dependence. Investigating the relationship between pain sensitivity and alcohol addiction prompts many important peripheral questions such as whether increased pain sensitivity can serve as a useful biomarker for alcohol addiction, and how addiction to alcohol can cause changes in sensitivity to pain. Addiction potential or risk for addiction is a research area that is extremely important given that the high rate of addiction in this country is alarmingly high. The literature is sparse on the relationship between hyperalgesia or pain sensitization and risk for alcohol addiction. This literature review synthesizes current relevant research on pain and addiction, as well as addressing possible links between them. / text

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Previous studies evaluating the impact of trauma history and PTSD on pain sensitivity yield inconsistent findings; the presence of trauma-related negative affective states may account for these discrepancies. Therefore, the proposed study aimed to evaluate the effect of trauma-related negative affect and PTSD symptoms on sensory and affective components of pain sensitivity among trauma-exposed women. Adult women (N = 87) with low and high PTSD symptoms underwent an emotional disclosure paradigm, during which they wrote about a traumatic event or a neutral topic. Participants then completed a pain induction procedure. Compared to women with low PTSD symptoms, women with high PTSD symptoms demonstrated increased time to pain detection (e.g., threshold) and ability to withstand pain (e.g., tolerance), as well as increased pain intensity and when accounting for relevant covariates. Women with high PTSD symptoms who wrote about their worst traumatic experience reported higher pain unpleasantness relative to women with high PTSD symptoms who wrote about the neutral topic and women with low PTSD symptoms who wrote about either topic. Results suggest that PTSD symptoms and trauma-related negative affect may facilitate alterations in pain sensitivity in trauma-exposed women, but this relationship is complex and requires further exploration.

This study sought to find the difference in pain sensitivity and psychological factors between men and women, and how an intervention such as stretching could generate effects of hypoalgesia. The primary aim of this study was to compare the difference in A-delta and C-fiber mediated thermal pain between sexes. The second aim was to compare pain-related psychological factors. Finally, the third aim was to compare changes in pressure pain threshold between men and women during the stretching intervention. Prior studies have already examined the relationship between stretching and conditioned pain modulation which was utilized towards this research. However, they have not included stretching to the point of pain, and conditioned pain modulation is often dependent on acquiring hypoalgesia through induction of pain. So, this study hypothesizes that stretching to the point of pain may induce effects of hypoalgesia in equal amount of higher than conditioned pain modulation. By conducting this research more information was acquired towards understanding the difference between sexes towards pain sensitivity and induction of hypoalgesia effects. Results of this study indicated that sex differences did not differ as much in response to the interventions, and psychological factors were deemed insignificant as well between sexes. However, looking at the responses of the total sample, after four minutes of stretching low intensity stretch was closely associated to hypoalgesia effects of the cold-water immersion in comparison to medium intensity stretch. In addition to that, inhibitory effects during cold-water immersion task displayed a significant association with higher heat pain threshold to the forearm and trapezius. As for psychological factors, in general, individuals with lower pain-anxiety had greater hypoalgesia effects to the cold-water immersion task.

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The purpose of this study was to evaluate the correlation between personality and pain perception in healthy adults. Thirty participants completed the study. All participants were asked to scan a QR code and fill out a survey on their phones that included demographic questions and the Eysenck personality inventory (EPI). The demographics section included questions on age, sex, job activity level, and physical activity level. The researcher then evaluated their pressure pain threshold (PPT) using a handheld pressure algometer. The algometer was applied to the regions of the right paravertebral (PVM), quadratus lumborum (QL), and piriformis (PF) muscles perpendicular to the skin based on standardized palpation procedures. The participants were instructed to report when the sensation changed from “comfortable” to “mildly unpleasant pressure.” Results suggest that there was a positive correlation between PPT applied to the different muscles but there was no strong correlation found between the participants extraversion score and neuroticism score and their PPT at different muscles. This study aids in the understanding of the relationship between personality and pain sensitivity by providing a better view on which tools are the most beneficial in assessing personality and how it relates to pain in a clinical setting.

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Title from first page of PDF document. Includes bibliographical references (p. 28-32).

BACKGROUND: Chronic low back pain (CLBP) is the leading cause of disability in the United States. People suffering from CLBP often have multiple comorbidities including depression, anxiety, and substance use disorder (SUD). Although the opioid epidemic has intensified the search for new treatment options, both pharmacological and other, opioids still remain the most common treatment for chronic pain. Long-term opioid therapy (LTOT) has been shown to lead to opioid-induced hyperalgesia (OIH), an increased sensitivity to painful stimuli. It remains unclear, however, the extent to which reductions in opioid dose impact OIH. METHODS: This is a longitudinal cohort study whose primary aim is to determine how changes in opioid doses are associated with changes in psychosocial and quantitative sensory testing (QST) variables. Participants were 24 adults with CLBP being treated with LTOT and visits were conducted on a monthly basis for six months. All 24 participants were included in the analysis of demographic and psychosocial variables (disability, anxiety, depression, opioid misuse, pain severity, pain interference, and catastrophizing). A subset of 13 participants were included in the analysis of QST variables. RESULTS: We found that pressure pain thresholds at the thumb and the trapezius, and heat pain threshold significantly (p < 0.05) improved between visit 1 and visit 6. We also found that a decrease in morphine equivalent doses (MED) is correlated (coefficient > 0.2) with improvements in punctuate probe rating, pain pressure at the thumb, and maximum cold ratings. DISCUSSION: Our results show that reductions in opioid dose are associated with reduced pain sensitivity, even while the psychosocial variables studied (including subjective pain score, depression, and anxiety) remain stable.

The assessment of pain in children has been an enduring theme in the research literature over many decades, with particular focus on how pain can be adequately measured and the extent of under-measurement of pain (American Academy of Pediatrics 2001; Coyne, 2006; McCaffery & Beebe 1989; Subhashini et al., 2009). Definitions of pain, and hence development of pain measurement tools, are often criticised for not addressing the influence of culture and ethnicity on pain (Bates et al., 1993; McCaffery & Beebe 1989; Zinke, 2007), in children, the perception and expression of pain is also affected by cognitive development (Hallström and Elander, 2004). Whilst there has been an increase in the number of children living in the United Kingdom (UK) who do not speak English as their first language, it has been acknowledged that the measurement and management of pain by health service professionals relies predominantly on their experience with English speaking children (RCN, 2009). This study aimed primarily to examine how primary school age children in key stage 1 who speak English as a primary or additional language experience, express, and explain pain. This aim was addressed through three research questions: (1) how do primary school age children in key stage 1 talk about pain? (2) What are the similarities and differences in the language used to talk about pain by children with English as a primary and additional language? (3) Are there differences in the perceptions of pain by children of different age, gender, language background, and country of birth? A second aim was to examine whether language would affect actions taken by final year child health students and nurses working in Minor Injuries Units to manage pain in primary school age children. Study objectives were addressed using a two phase mixed methods design. The first aim was addressed using six focus group interviews with groups of primary school children (aged 4-7) (Phase 1). Two methods were used in the interviews: use of drawings from the Pediatric Pain Inventory (Lollar et al., 1982) to capture the language used by children to describe pain and observation of the children’s placing of pain drawings on red/amber/green paper to denote perceived severity of pain. Following data collection, the vocabulary of each child was assessed using a standardised lexical test (British Picture Vocabulary Score version II - BPVS II) (Dunn et al., 1997). To address the second aim, a factorial survey was conducted (Phase 2) with nurses working in Minor Injuries Units and child health nursing students to determine whether language has an impact on decisions made about the management of children in pain following a minor injury. Phase 1 findings demonstrated that children from English as an Additional Language (EAL) backgrounds used less elaborate language when talking about pain but tended to talk about the pictures prior to deciding where they should be placed. The children’s placement of pain drawings varied according to language background, gender, and age. The calculated language age of English lexical comprehension (BPVS II score) of monolingual children (M=69.85, SD=19.27) was significantly higher than EAL children (M=47.93, SD=14.32; t (32) = 3.60, p =0.001, two-tailed). However, when these differences were explored in terms of year group, the differences remain significant with foundation and year 2 but not with year 1. For the EAL children, there were also significant relationships between BPVS II score and length of stay in the UK (spearman’s rho 0.749, p = 0.33). The Phase 1 findings were used to construct vignettes, describing hypothetical care situations, for Phase 2. Multinomial logistic regression was used to analyse the impact of a child’s age, gender, language, parent’s language, injury mechanism, and reaction to pain on the way in which the child’s pain would be assessed and whether parents or an interpreter would be invited to assist in pain assessment. Findings demonstrated that observing the child’s behaviour is the most significant assessment process that is used to assess EAL children, rather than the Visual Analogue Scale (VAS), which was used with non-EAL children. This is significant as VAS is the mostly widely used tool to assess pain in health care settings. However, VAS is only effective if it can be understood by the child. Further, MIU nurses and child health students were more likely to involve parents who speak English well than those who speak English poorly but would ask for an interpreter if their involvement was necessary. In order for the respondents to explain their decisions, they were asked an open ended question for each vignette. They reported that language and age of children are the most common difficulties they faced during assessment of pain. Therefore, they suggested some solutions, like using an age appropriate tools for assessing younger children. Respondents also identified that using an interpreter is a time consuming process, which might delay the management of pain. In light of the growing numbers of EAL children in the UK; this research has application in a number of contexts. The variation in language would apply if children were reporting their own pain. However, the findings emphasise the need for sufficient time to be allocated to pain assessment to allow an individualised approach. Study findings suggest several factors that may be important in assessing pain in EAL children; these should be explored further in the context of clinicians’ assessment of pain. The implications of the study impact on policy, practice, education, and future research.