Individual Dynamics in Stress-Related Pain Responses

BackgroundStress and pain are two adaptive mechanisms, driving human behavior and cognition. They are bidirectionally related, and modulating factors such as sleep or physical activity were identified. However, how stable individual differences in pain-related distress, including individual dispositions for pain catastrophizing, and person-specific pain sensitivities relate to the strength of stress responses remains unclear. This preregistered study closes this gap by investigating how trait pain-related distress and pain sensitivity changes relate to individuals stress response. MethodsTrait pain-related distress was assessed in 148 healthy males with the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, and the Fear of Pain Questionnaire. Baseline blood pressure, pulse rate, alpha-amylase, and cortisol were obtained as well as initial heat pain thresholds and tolerances. One participant group underwent the Maastricht Acute Stress Task, while a control group performed the placebo version of this task, and consecutively all stress- and experimental pain indicators were examined again. ResultsIndividuals with lower kinesiophobia demonstrated higher stress-induced increases in alpha-amylase. Furthermore, stress-induced changes in pain sensitivity showed high individual variability, but were not associated with the stress response. Finally, in individuals with a higher tendency to catastrophize and to fear pain, stronger alpha-amylase increases were associated with larger post-stressor increases in pain threshold, indicating reduced pain sensitivity. ConclusionOur study suggests that stable individual differences influence the stress-pain link beyond physiology. This underscores the importance of considering trait differences in future research on stress-pain interactions with the goal of better tailoring preventions and treatments for patients with chronic pain.