The long‐term impact of tissue injury on pain processing and modulation: A study on ex‐prisoners of war who underwent torture

Defrin, Ruth; Ginzburg, Karni; Mikulincer, Mario; Solomon, Zahava

doi:10.1002/j.1532-2149.2013.00394.x

Cited by 30 publications

(14 citation statements)

References 56 publications

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“…Pressing the switch resulted in an automatic recording of the threshold temperature and reset the probe temperature to baseline value. Pain threshold and pain tolerance were computed separately by averaging the readings of 4 successive stimuli in each measurement [20].…”

Section: Pain Threshold and Pain Tolerancementioning

confidence: 99%

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Acute psychosocial stress reduces pain modulation capabilities in healthy men

Geva

Pruessner

Defrin

2014

Pain

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Anecdotes on the ability of individuals to continue to function under stressful conditions despite injuries causing excruciating pain suggest that acute stress may induce analgesia. However, studies exploring the effect of acute experimental stress on pain perception show inconsistent results, possibly due to methodological differences. Our aim was to systematically study the effect of acute stress on pain perception using static and dynamic, state-of-the-art pain measurements. Participants were 29 healthy men who underwent the measurement of heat-pain threshold, heat-pain intolerance, temporal summation of pain, and conditioned pain modulation (CPM). Testing was conducted before and during exposure to the Montreal Imaging Stress Task (MIST), inducing acute psychosocial stress. Stress levels were evaluated using perceived ratings of stress and anxiety, autonomic variables, and salivary cortisol. The MIST induced a significant stress reaction. Although pain threshold and pain intolerance were unaffected by stress, an increase in temporal summation of pain and a decrease in CPM were observed. These changes were significantly more robust among individuals with stronger reaction to stress ("high responders"), with a significant correlation between the perception of stress and the performance in the pain measurements. We conclude that acute psychosocial stress seems not to affect the sensitivity to pain, however, it significantly reduces the ability to modulate pain in a dose-response manner. Considering the diverse effects of stress in this and other studies, it appears that the type of stress and the magnitude of its appraisal determine its interactions with the pain system.

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Section: Pain Threshold and Pain Tolerancementioning

confidence: 99%

“…This effect may operate via the aforementioned pathways. The deficient CPM among torture survivors suffering from high levels of posttraumatic stress disorders [20] supports such a possibility, but further study is needed to elaborate on this issue.…”

Section: The Effect Of Stress On Pain Modulationmentioning

confidence: 99%

Acute psychosocial stress reduces pain modulation capabilities in healthy men

Geva

Pruessner

Defrin

2014

Pain

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“…Attachment theories traditionally posit that the predominant influence on one's attachment style is the experiences they have with primary caregivers during formative developmental years during childhood, and that these attachment tendencies persist to adulthood (Bowlby, 1969). More recent adaptations of attachment theory propose that other life experiences can modulate attachment style, including events that violate one's secure attachment representations (Defrin et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Attachment style and interpersonal trauma in refugees

Morina

Schnyder

Schick

et al. 2016

Aust N Z J Psychiatry

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Exposure to interpersonal traumatic events, including torture, is associated with enduring avoidant attachment tendencies in refugees. This finding accords with attachment theories that prior adverse interpersonal experiences can undermine secure attachment systems, and may promote avoidance of attachment seeking. This finding may point to an important process maintaining poor psychological health in refugees affected by interpersonal trauma.

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“…Psychological or physical torture may inflict ‘pain,’ but memories of pain may also be blunted as a result of impaired memory formation due to stress (Defrin et al, 2017). There seems to be a powerful interaction between pain and emotional processing: on the one hand, the level of pain predicts psychological sequelae (de C Williams and van der Merwe, 2013), while the type of psychological stress, rather than the trauma per se, has a significant effect on pain modulation and perception (Defrin et al, 2014, 2017). “ Torture appears to induce generalized dysfunctional pain modulation that may underlie the intense chronic pain experienced by torture survivors decades after torture ”.…”

Section: When Pain Pops Out To Conscious Awareness – Insights Frommentioning

confidence: 99%

Subliminal (latent) processing of pain and its evolution to conscious awareness

Borsook

Youssef

Barakat

et al. 2018

Neuroscience & Biobehavioral Reviews

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By unconscious or covert processing of pain we refer to nascent interactions that affect the eventual deliverance of pain awareness. Thus, internal processes (viz., repeated nociceptive events, inflammatory kindling, re-organization of brain networks, genetic) or external processes (viz., environment, socioeconomic levels, modulation of epigenetic status) contribute to enhancing or inhibiting the presentation of pain awareness. Here we put forward the notion that for many patients, ongoing sub-conscious changes in brain function are significant players in the eventual manifestation of chronic pain. In this review, we provide clinical examples of nascent or what we term pre-pain processes and the neurobiological mechanisms of how these changes may contribute to pain, but also potential opportunities to define the process for early therapeutic interventions.

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The long‐term impact of tissue injury on pain processing and modulation: A study on ex‐prisoners of war who underwent torture

Cited by 30 publications

References 56 publications

Acute psychosocial stress reduces pain modulation capabilities in healthy men

Acute psychosocial stress reduces pain modulation capabilities in healthy men

Attachment style and interpersonal trauma in refugees

Subliminal (latent) processing of pain and its evolution to conscious awareness

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