The effect of resilience on task persistence and performance during repeated exposure to heat pain

Abstract

The Pain Resilience Scale was recently developed to assess dimensions of resilience critical to pain-related adaptation and was found to predict experimental pain sensitivity in a pain-free population. Pain resilience has also been theoretically linked to behavioral persistence despite pain. To date, however, this hypothesis has not been experimentally tested. To address this gap in the literature, in the current study 105 healthy young adults underwent a baseline administration of the Paced Auditory Serial Addition Test (PASAT), a stressful mental arithmetic task, delivered with somatosensory distraction (i.e. detection of warm and cool thresholds), and finally simultaneous administration of the PASAT and a series of five heat pain threshold assessments. Results of hierarchical multiple linear regressions indicated that, after controlling for scores on a baseline PASAT and pain sensitivity, pain resilience was positively related to task persistence, B = 0.12, p = 0.04, and task performance, B = 0.14, p = 0.04, on the PASAT. These findings provide novel support for the relationship between pain resilience and behavioral perseverance.

Pain resilience and catastrophizing combine to predict functional restoration program outcomes.

“…The overall scale includes 14 items (four cognitive, five affective, and five behavioral) that respondents rate from 0 ( not at all ) to 4 ( all the time ), resulting in a full-scale score that can range from 0 to 56. An example of a cognitive/affective positivity item is “I keep a positive attitude.” An example of a behavioral perseverance item is “I push through it.” In prior validation studies conducted in the context of experimental pain (Slepian et al, 2016; Slepian & France, 2017) or chronic pain (Ankawi et al, 2017), the scale has demonstrated high internal consistency (α = 0.92–0.93), adequate test-retest reliability (intraclass correlation coefficient = 0.80) over a 1-month interval, positive correlations with measures of general resilience such as the Connor-Davidson Resilience Scale ( r = 0.68) and the Brief Resilience Scale ( r = 0.45), and negative correlations with the Pain Catastrophizing Scale ( r = −0.31 to −0.49). Consistent with prior work, in the present sample, admission scores on the Pain Resilience Scale and Pain Catastrophizing Scale were inversely correlated ( r = −0.40, p < .001), suggesting a moderate amount of shared variance.…”

“…Whereas numerous conceptualizations of psychosocial resilience as a general construct have been forwarded, a more pain-specific scale was developed to capture individual differences in cognitive/affective regulation and behavioral persistence despite the presence of intense or prolonged pain (Slepian et al, 2016). Initial validation of this measure, conducted with healthy participants exposed to noxious experimental pain, demonstrated that pain resilience was related to lower pain responsivity (Slepian et al, 2016) and enhanced task persistence and performance (Slepian & France, 2017). In addition to the expected inverse relationship between pain resilience and pain catastrophizing, pain resilience contributed unique variance to the prediction of self-reported pain and task persistence.…”

(156) The Effect of Pain Resilience on Pain Experience: Does Stimulus Matter?

“…Rather, they would be expected to remain engaged in a task and more capably regulate their cognitions and emotions during a painful task, possibly contributing to better performance on that task. For example, Slepian and France (2017) Affective outcomes include depression and other negative emotions (Berendes et al, 2010;Hsu, Lu, Tsou, & Lin, 2003;Kilic, Dorstyn, & Guiver, 2013;Strand et al, 2006;Viggers & Caltabiano, 2012;Zautra, Johnson, & Davis, 2005;Zautra, Smith, Affleck, & Tennen, 2001), anxiety (Kilic et al, 2013;Viggers & Caltabiano, 2012), stress (Kilic et al, 2013;Viggers & Caltabiano, 2012;Wright et al, 2011), and quality of life (Ankawi et al, 2017). These findings suggest that using pain ratings as the sole outcome variable likely provides an incomplete picture of pain adaptation.…”

Psychophysiological correlates of pain resilience in anticipating, experiencing, and recovering from pain

“…Although operationalizations have varied, resilience reflects capacities to maintain a positive outlook, persevere, and function adaptively despite adversity or ongoing stressors including pain (Connor & Davidson, 2003;Slepian et al, 2016;Sturgeon & Zautra, 2013). Behavior studies of laboratory pain have found elevations in pain resilience are related to lower pain intensity levels (Ankawi et al, 2020;Slepian et al, 2016), increases in pain tolerance (Slepian et al, 2016;Slepian & France, 2017), an enhanced capacity to disengage visual attention from painful cues (Jackson et al, 2019;Ling et al, 2019), and superior performance on cognitive tasks accompanied by painful stimulation (Li & Jackson, 2020). Furthermore, brain-imaging research has begun to reveal brain structure correlates of pain resilience.…”

“…Two hypotheses were tested. First, because less resilient persons typically have a diminished capacity to function well in the face of pain (Ankawi et al, 2020;Chen & Jackson, 2018;Slepian & France, 2017), we expected lower pain resilience subgroup members would report significantly more anxiety and expect more pain than would members of moderate, and especially, higher pain resilience subgroups during pain anticipation. Second, although previous studies found inconsistent associations between resilience and physiological indexes during the anticipation and cessation of stressors (Hildebrandt et al, 2016;Spangler, 1997), we expected high resilience subgroup members would experience significantly lower physiological activity across pain anticipation, painful stimulation, and recovery from painful stimulation phases compared to moderate, and especially, lower pain resilience subgroups based on conceptually related stress literature (Lü et al, 2016;Souza et al, 2007;).…”