TY - JOUR
T1 - Distraction analgesia in chronic pain patients the impact of catastrophizing
AU - Schreiber, Kristin L.
AU - Campbell, Claudia
AU - Martel, Marc O.
AU - Greenbaum, Seth
AU - Wasan, Ajay D.
AU - Borsook, David
AU - Jamison, Robert N.
AU - Edwards, Robert R.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2014/12/4
Y1 - 2014/12/4
N2 - Background: Diverting attention away from noxious stimulation (i.e., distraction) is a common pain-coping strategy. Its effects are variable across individuals, however, and the authors hypothesized that chronic pain patients who reported higher levels of pain catastrophizing would derive less pain-reducing benefit from distraction.Methods: Chronic pain patients (n = 149) underwent psychometric and quantitative sensory testing, including assessment of the temporal summation of pain in the presence and absence of a distracting motor task.Results: A simple distraction task decreased temporal summation of pain overall, but, surprisingly, a greater distraction analgesia was observed in high catastrophizers. This enhanced distraction analgesia in high catastrophizers was not altered when controlling for current pain scores, depression, anxiety, or opioid use (analysis of covariance [ANCOVA]: F = 8.7, P < 0.005). Interestingly, the magnitude of distraction analgesia was inversely correlated with conditioned pain modulation (Pearson R = -0.23, P = 0.005).Conclusion: Distraction produced greater analgesia among chronic pain patients with higher catastrophizing, suggesting that catastrophizing's pain-Amplifying effects may be due in part to greater attention to pain, and these patients may benefit from distraction-based pain management approaches. Furthermore, these data suggest that distraction analgesia and conditionedpain modulation may involve separate underlying mechanisms.
AB - Background: Diverting attention away from noxious stimulation (i.e., distraction) is a common pain-coping strategy. Its effects are variable across individuals, however, and the authors hypothesized that chronic pain patients who reported higher levels of pain catastrophizing would derive less pain-reducing benefit from distraction.Methods: Chronic pain patients (n = 149) underwent psychometric and quantitative sensory testing, including assessment of the temporal summation of pain in the presence and absence of a distracting motor task.Results: A simple distraction task decreased temporal summation of pain overall, but, surprisingly, a greater distraction analgesia was observed in high catastrophizers. This enhanced distraction analgesia in high catastrophizers was not altered when controlling for current pain scores, depression, anxiety, or opioid use (analysis of covariance [ANCOVA]: F = 8.7, P < 0.005). Interestingly, the magnitude of distraction analgesia was inversely correlated with conditioned pain modulation (Pearson R = -0.23, P = 0.005).Conclusion: Distraction produced greater analgesia among chronic pain patients with higher catastrophizing, suggesting that catastrophizing's pain-Amplifying effects may be due in part to greater attention to pain, and these patients may benefit from distraction-based pain management approaches. Furthermore, these data suggest that distraction analgesia and conditionedpain modulation may involve separate underlying mechanisms.
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U2 - 10.1097/ALN.0000000000000465
DO - 10.1097/ALN.0000000000000465
M3 - Article
C2 - 25264596
AN - SCOPUS:84914149180
VL - 121
SP - 1292
EP - 1301
JO - Anesthesiology
JF - Anesthesiology
SN - 0003-3022
IS - 6
ER -