Emotional distress and pain tolerance in obsessive-compulsive disorder

Hezel, Dianne M.; Riemann, Bradley C.; McNally, Richard J.

doi:10.1016/j.jbtep.2012.03.005

Cited by 31 publications

(31 citation statements)

References 44 publications

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“…This design was able to maintain good temperature uniformity to 33 ± 1° F without need of a water circulator. As before, threshold was the total time elapsed from task onset until the participant reported pain, tolerance was the total time elapsed from task onset until the participant removed his or her hand (maximum five minutes for safety), and endurance was the difference between tolerance and threshold (44,45). If a participant reached the 5-minute safety limit for threshold and/or tolerance, he or she was asked to remove his or her hand from the CP's ice water bath and a 300 second threshold and/or tolerance time was recorded.…”

Section: Methodsmentioning

confidence: 99%

“…For CP, endurance was calculated as the difference between tolerance and threshold; it therefore was not an independent variable. Statistical analysis comprised mixed ANOVA and t -tests, common for these types of psychological tasks (41,44–50), as well as Shapiro-Wilk tests of dataset normality. Stimulation polarity was the within-participants factor; stimulation order (i.e.…”

Section: Methodsmentioning

confidence: 99%

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Transcranial Direct Current Stimulation (tDCS) Targeting Left Dorsolateral Prefrontal Cortex Modulates Task-Induced Acute Pain in Healthy Volunteers

et al. 2015

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Objective Current chronic pain treatments target nociception rather than affective “suffering” and its associated functional and psychiatric comorbidities. Left dorsolateral prefrontal cortex (DLPFC) has been implicated in affective, cognitive, and attentional aspects of pain and is a primary target of neuromodulation for affective disorders. Transcranial direct current stimulation (tDCS) can noninvasively modulate cortical activity. The present study tests if anodal tDCS targeting left DLPFC will increase tolerability of acute painful stimuli versus cathodal tDCS. Methods Forty tDCS-naive healthy volunteers received anodal and cathodal stimulation targeting left DLPFC in two randomized and counterbalanced sessions. During stimulation, each participant performed cold pressor (CP) and breath holding (BH) tasks. We measured pain intensity with the Defense and Veterans Pain Rating Scale (DVPRS) before and after each task. Results Mixed ANOVA revealed no main effect of stimulation polarity for mean CP threshold, tolerance, or endurance, or mean BH time (all p > 0.27). However, DVPRS rise associated with CP was significantly smaller with anodal versus cathodal tDCS (p = 0.024). We further observed a significant tDCS polarity × stimulation order interaction (p = 0.042) on CP threshold suggesting task sensitization. Conclusions Although our results do not suggest that polarity of tDCS targeting left DLPFC differentially modulates tolerability of CP- and BH-related pain distress in healthy volunteers, there was a significant effect on DVPRS pain ratings. This contrasts with our previous findings that tDCS targeting left dorsal anterior cingulate cortex showed a trend towards higher mean CP tolerance with cathodal versus anodal stimulation. The present results may suggest tDCS-related effects on nociception or DLPFC-mediated attention, or preferential modulation of the affective valence of pain as captured by DVPRS. Sham-controlled clinical studies are needed.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Transcranial Direct Current Stimulation (tDCS) Targeting Left Dorsolateral Prefrontal Cortex Modulates Task-Induced Acute Pain in Healthy Volunteers

et al. 2015

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“…Additional DVPRS ratings were obtained immediately after each of the three pain distress tolerance tasks described below. For these tasks, threshold was defined as the time elapsed (in seconds) from task onset to when the participant first reported pain, and tolerance was defined as time elapsed from task onset to when the participant ended the task .…”

Section: Methodsmentioning

confidence: 99%

Effects of Transcranial Direct Current Stimulation (tDCS) on Pain Distress Tolerance: A Preliminary Study

Mariano¹,

Wout-Frank²,

Jacobson³

et al. 2015

Pain Med

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Objective Pain remains a critical medical challenge. Current treatments target nociception without addressing affective symptoms. Medically intractable pain is sometimes treated with cingulotomy or deep brain stimulation to increase tolerance of pain-related distress. Transcranial direct current stimulation (tDCS) may noninvasively modulate cortical areas related to sensation and pain representations. The present study aimed to test the hypothesis that cathodal (“inhibitory”) stimulation targeting left dorsal anterior cingulate cortex (dACC) would increase tolerance to distress from acute painful stimuli versus anodal stimulation. Methods Forty healthy volunteers received both anodal and cathodal stimulation. During stimulation, we measured pain distress tolerance with three tasks: pressure algometer, cold pressor, and breath holding. We measured pain intensity with a visual-analog scale before and after each task. Results Mixed ANOVA revealed that mean cold pressor tolerance tended to be higher with cathodal versus anodal stimulation (p = 0.055) for participants self-completing the task. Pressure algometer (p = 0.81) and breath holding tolerance (p = 0.19) did not significantly differ. The pressure algometer exhibited a statistically significant order effect irrespective of stimulation polarity (all p < 0.008). Pain intensity ratings increased acutely after cold pressor and pressure algometer tasks (both p < 0.01), but not after breath holding (p = 0.099). Cold pressor pain ratings tended to rise less after cathodal versus anodal tDCS (p = 0.072). Conclusions Although our primary results were nonsignificant, there is a preliminary suggestion that cathodal tDCS targeting left dACC may increase pain distress tolerance to cold pressor. Pressure algometer results are consistent with task-related sensitization. Future studies are needed to refine this novel approach for pain neuromodulation.

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“…Though research linking DT and OCD is limited, initial evidence has demonstrated that lower DT is associated with greater severity of OCD symptoms, particularly obsessions, in both clinical and nonclinical samples (Cougle, Timpano, & Goetz, ; Cougle, Timpano, Fitch, & Hawkins, ; Keough et al., ; Laposa et al., ; Macatee, Capron, Schmidt, & Cougle, ). Additionally, Hezel and colleagues () found that participants with OCD have significantly lower DT compared to healthy controls. It is hypothesized that low DT may interfere with goal‐driven behavior in the context of distress, allowing DT to be a possible risk factor for the maintenance and development of maladaptive behaviors (McHugh et al., ).…”

Section: Introductionmentioning

confidence: 99%

Validation of the distress tolerance scale‐short form in obsessive compulsive disorder

et al. 2017

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Emotional distress and pain tolerance in obsessive-compulsive disorder

Cited by 31 publications

References 44 publications

Transcranial Direct Current Stimulation (tDCS) Targeting Left Dorsolateral Prefrontal Cortex Modulates Task-Induced Acute Pain in Healthy Volunteers

Transcranial Direct Current Stimulation (tDCS) Targeting Left Dorsolateral Prefrontal Cortex Modulates Task-Induced Acute Pain in Healthy Volunteers

Effects of Transcranial Direct Current Stimulation (tDCS) on Pain Distress Tolerance: A Preliminary Study

Validation of the distress tolerance scale‐short form in obsessive compulsive disorder

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