Date of Graduation
Persons with chronic pain often display extreme disability, distress, and other pain behaviors. It is clear that behavioral factors significantly contribute to the consequences of pain for many of these persons. The purpose of this study was to investigate relations of fearful cognitions about pain with other anxiety responses to pain including subjective reports of anxiety, physiological responses, and amount of activity during painful and nonpainful physical tasks. To show that these responses covary is to suggest that the same principles that apply to anxiety behaviors may apply equally well to the behavior of persons with chronic pain and that these principles may explain the strength and persistence of pain behaviors some of these individuals. In this study 34 subjects (age, M = 40.9, SD = 9.9; 32.4% female) with chronic low back pain were exposed to repetitive painful and nonpainful activities. Skin conductance, heart rate, and anxiety ratings were collected during anticipatory periods that immediately preceded the activities. Range of motion, number of repetitions, pain predications, and pain ratings also were assessed. Subjects who reported more fearful cognitions about pain were compared to persons with chronic back pain who reported fewer of these cognitions. Results demonstrated that, compared to the low fear subjects, the high fear subjects had greater skin conductance overall, greater increases in skin conductance level in anticipation of painful activity, and less range of motion at the point of pain tolerance. Also, after statistically controlling for pain level during activity, the high fear subjects performed fewer repetitions of a painful activity compared to a nonpainful activity while low fear subjects performed similar numbers of repetitions under both conditions. Both statistical and visual inspection of the data showed that high fear subjects tended to show sensitization of anxious responding on the second trial of painful activity while the low fear subjects tended to show habituation. The results of this study lend further support to the notion that anxiety-related processes can play a role in the persistence and severity of chronic pain behavior.
McCracken, Lance Maxwell, "A multimodal analysis of pain-related anxiety: Relations between anxiety reports, physiological responses, and avoidance during painful and non-painful movement." (1993). Graduate Theses, Dissertations, and Problem Reports. 9386.