Depressive Attribution Style and Stressor Uncontrollability Increase Perceived Pain Intensity after Electrical Skin Stimuli in Healthy Young Men

Abstract

Many patients with major depression report painful physical complaints (1). In addition, a large proportion of patients with chronic pain suffer from depression. Fibromyalgia is a disorder sharing common features of both depression and pain disorders (2,3). Recent studies have shown that higher perceived pain intensities and negative pain-related cognitions were associated with depression in chronic pain patients (4) and with lower quality of life in patients with major depression and pain complaints (5). However, it remains unclear whether specific depression-related cognitive schemata and states predispose to intensified pain perception and the development of chronic pain, or whether acute and chronic pain may worsen or even cause depression. The great impact of persistent painful states and pain treatment on depressive symptoms and related cognitions has been demonstrated (6). Accordingly, situational dysfunctional cognitions have been linked to lower thresholds and higher intensity ratings after experimentally induced pain, whereas dispositional measurements have not (7). The predictive properties of cognitive schemata associated with depression as risk factors for the development of painful states have, thus, been questioned.Basic research has revealed specific cognitive and emotionalaffective components of neurobiological pain processing (8-10), which likely contribute to the clinically relevant overlap between depressive and pain disorders. Specifically, uncontrollability and unpredictability of painful stressors have been demonstrated to be extremely important modifiers of pain perception (11-13). Unpleasantness and helplessness of potentially painful stimuli appear to be associated with increased BackgRounD: Depressive and pain symptoms often occur concurrently in patients with psychiatric disorders or somatic diseases, but the contribution of pre-existing dysfunctional cognitive schemata to pain perception remains unclear. oBJective: To investigate the relationship between depression-related attribution styles and perceived pain intensity (PPI) after controllable versus uncontrollable electrical skin stimulation in healthy male individuals. MethoDs: Causal attributions for negative events were measured using the attribution style questionnaire (ASQ) on the dimensions internal versus external (INT), global versus specific (GLO) and stable versus unstable (STA) in 50 men (20 to 31 years of age). Additionally, symptoms of anxiety and depression (measured using the Depression Scale) as well as baseline helplessness were assessed. Participants were randomly assigned to receive self-administered (controllable) or experimenter-administered (uncontrollable) painful skin stimuli. PPI was assessed after stress exposure using a visual analogue scale (0 to 100). Relationships between PPI and depression-related cognitions were calculated using correlation and multiple regression analyses. Results: Correlation analyses revealed a moderate correlation between PPI and ASQ-INT scores (r=0.46). Following uncontrollable ...

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Internal but not external locus of control predicts acute stress response

“…According to the literature, being exposed to uncontrollable aversive events might result in more intense physiological activation (Müller, 2011; Peters et al, 1999, 2003). However, having access to control was found to effectively mitigate the harmful effects of stressful situations (Henderson et al, 2012; Müller, 2012, 2013). Meanwhile, stable psychological determinants such as early life experiences, coping styles, and personality traits have been identified to influence physiological stress reactivity (Janson & Rohleder, 2017; Juster et al, 2012; Kudielka et al, 2009; Oswald et al, 2006; Zhang et al, 2019).…”