Athletes' inclination to play through pain: a coping perspective

Previous studies have shown how social networks lead athletes to accept pain as a "part of the game," which generates pressure on athletes to continue competing despite being in pain. Little is known, however, about the potential coping strategies that are related to pain behavior in sport. This study of 205 combat athletes examined whether pain coping strategies, including distraction from pain, praying, reinterpreting pain sensations, ignoring pain, and pain catastrophizing, are related to athletes' inclination to play through pain. Results revealed that pain catastrophizing led athletes to reduce their physical involvement in their sport activity. Of particular interest was the moderating effect of ignoring pain such that ignoring pain significantly attenuated the negative effect of pain intensity on athletes' inclination to play through pain. Few studies have tested and supported the contribution of pain coping to the prediction of behavior in real sport situations. By identifying which coping strategies athletes could use to maintain their physical involvement despite being in (sometimes intense) pain, the current study makes an important contribution for tailoring pain management programs for this at-risk population.     

Athletes' inclination to play through pain: a coping perspective

Previous studies have shown how social networks lead athletes to accept pain as a “part of the game,” which generates pressure on athletes to continue competing despite being in pain. Little is known, however, about the potential coping strategies that are related to pain behavior in sport. This study of 205 combat athletes examined whether pain coping strategies, including distraction from pain, praying, reinterpreting pain sensations, ignoring pain, and pain catastrophizing, are related to athletes’ inclination to play through pain. Results revealed that pain catastrophizing led athletes to reduce their physical involvement in their sport activity. Of particular interest was the moderating effect of ignoring pain such that ignoring pain significantly attenuated the negative effect of pain intensity on athletes’ inclination to play through pain. Few studies have tested and supported the contribution of pain coping to the prediction of behavior in real sport situations. By identifying which coping strategies athletes could use to maintain their physical involvement despite being in (sometimes intense) pain, the current study makes an important contribution for tailoring pain management programs for this at-risk population.     

疼痛表情对秒下及秒上时距知觉的影响

采用二分法和泛化法范式,在秒下及秒上呈现时距探究疼痛表情对时距知觉的影响。结果发现,使用二分法,疼痛表情在秒上秒下都显著延长了个体的主观时距,但使用泛化法,疼痛表情仅在秒上产生影响。根据时间分段综合模型和范式特点,该实验结果反映疼痛表情对时距知觉的影响在秒上秒下的作用机制可能不同,在秒下主要是通过唤醒影响,在秒上则可能由唤醒和注意共同调节。     

The effect of pain and the anticipation of pain on temporal perception: A role for attention and arousal

The overestimation of the duration of fear-inducing stimuli relative to neutral stimuli is a robust finding within the temporal perception literature. Whilst this effect is consistently reported with auditory and visual stimuli, there has been little examination of whether it can be replicated using painful stimulation. The aim of the current study was, therefore, to explore how pain and the anticipation of pain affected perceived duration of time. A modified verbal estimation paradigm was developed in which participants estimated the duration of shapes previously conditioned to be associated with pain, compared to those not associated with pain. Duration estimates were significantly longer on trials in which pain was received or anticipated than on control trials. Slope and intercept analysis revealed that the anticipation of pain resulted in steeper slopes and greater intercept values than for control trials. The results suggest that increased arousal and attention, when anticipating and experiencing pain, result in longer perceived durations. The results are discussed in relation to internal clock theory and neurocognitive models of time perception.     

Is the Effect of Behavioral Synchrony on Cooperative Behavior Mediated by Pain Threshold?

Synchronized behavior results in a variety of prosocial behaviors. Research has also implicated that interpersonal synchrony affects pain thresholds, inferred as indicative of endorphin levels. The current study was designed to see if these pain threshold effects mediated the effect of synchrony on interpersonal cooperation. Twenty six individuals were randomly assigned to complete a 30 minute run on a treadmill in either a synchronized or nonsynchronized condition. Pain threshold was measured both before and after exercise as an indicator of endorphin activity. A postrun social investment game measured interpersonal cooperation. Analyses showed that there was a significant direct relationship between condition and cooperation but that this effect was not mediated by pain threshold.     

Fear of pain is elevated in adults with co-occurring trauma-related stress and social anxiety symptoms

The aim of this study was to determine whether fear of pain and related fear constructs are elevated in people with co-occurring trauma-related stress and social anxiety symptoms relative to people with 1 or neither of these conditions. Eighty students were selected from a larger sample and divided into 4 equal groups comprising those with both high trauma-related stress and social anxiety symptom scores (TRS/SAS), only high trauma-related stress symptom scores (TRS), only high social anxiety symptom scores (SAS), or neither (N). Results indicated that the TRS/SAS group had significantly higher scores on all fear of pain measures, anxiety sensitivity, and illness/injury sensitivity than any other group, even when level of current pain was included as a covariate. These findings suggest that people with co-occurring trauma-related and social anxiety symptoms are most likely to be fearful of pain and to thereby be at increased risk of developing chronic and disabling pain. Implications for future research and treatment are discussed.     

The effect of situation-evoked anxiety and gender on pain report using the cold pressor test

The aims of the present study were to investigate the influence of anxiety on pain perception and to test whether gender differences in pain perception are anxiety dependent. Sixty male and female university students exposed to situation-evoked anxiety or a control procedure were measured for their pain threshold, tolerance, and perceived intensity during a cold pressor test. Both subjective and autonomic responses indicated that anxiety was successfully induced in participants exposed to the anxiety condition. Increased situational anxiety had no significant effect on pain threshold or pain tolerance. Significant increases in pain intensity were found for the anxiety group. Levels of anxiety, however, did not correlate with this increased intensity, raising doubt as to the role of anxiety in producing this effect. No gender differences were found for pain tolerance or pain intensity. Gender differences were found for pain threshold in the anxiety group with, contrary to past findings, females showing significantly higher pain thresholds than males. The results are discussed in the light of related studies.     

Fear of Pain is Elevated in Adults with Co‐Occurring Trauma‐Related Stress and Social Anxiety Symptoms

The aim of this study was to determine whether fear of pain and related fear constructs are elevated in people with co‐occurring trauma‐related stress and social anxiety symptoms relative to people with 1 or neither of these conditions. Eighty students were selected from a larger sample and divided into 4 equal groups comprising those with both high trauma‐related stress and social anxiety symptom scores (TRS/SAS), only high trauma‐related stress symptom scores (TRS), only high social anxiety symptom scores (SAS), or neither (N). Results indicated that the TRS/SAS group had significantly higher scores on all fear of pain measures, anxiety sensitivity, and illness/injury sensitivity than any other group, even when level of current pain was included as a covariate. These findings suggest that people with co‐occurring trauma‐related and social anxiety symptoms are most likely to be fearful of pain and to thereby be at increased risk of developing chronic and disabling pain. Implications for future research and treatment are discussed.     

Mothers' facial expressions of pain and fear and infants' pain response during immunization

The goal of the current study was to examine the relationship between mothers' spontaneous facial expressions of pain and fear immediately preceding their infants' immunizations and infants' facial expressions of pain immediately following immunizations. Infants' observations of mothers' faces prior to immunization also were examined to explore whether these observations moderated the effect of mothers' facial expressions on infant pain. The final sample included 58 mothers and their infants. Video data were used to code maternal facial expressions, infants' observations, and infants' expressions of pain. Infants who observed their mothers' faces had mothers who expressed significantly more fear pre‐needle. Furthermore, mothers' facial expressions of mild fear pre‐needle were associated with lower levels of infants' pain expression post‐needle. A regression analysis confirmed maternal facial expressions of mild fear pre‐needle as the strongest predictor of infant pain post‐needle after controlling for infants' observations of mothers' faces. Mothers' subtle facial expressions of fear may indicate a relationship history of empathic caregiving that functions to support infants' abilities to regulate distress following painful procedures. Interventions aimed at improving caregiver sensitivity to infants' emotional cues may prove beneficial to infants in pain. Future directions in research are discussed.     

Social Support and Depression in Rheumatoid Arthritis: A One-Year Prospective Study1

Previous research on patients with rheumatoid arthritis (RA) has suggested that social support is beneficial for helping patients to adjust psychologically to the chronic and unpredictable episodes of pain. This study addresses whether support buffers the adverse effects of arthritis pain or whether support results in a decrease in the severity of pain regardless of pain levels in 233 RA patients. The results indicated that patients who reported higher satisfaction with their emotional support when experiencing higher levels of pain were less likely to be depressed than patients who do not perceive such support. The results were obtained after controlling the effects of demographic variables, functional disability variables, and the direct effects of pain and social support. However, moderating effects of emotional support were not found when this relationship was examined over a 6-month period. Rather, causal modeling suggested that both pain and emotional support contributed to a change in depression over two 6-month intervals. The results also suggested that depression may have an adverse effect on change in emotional support over a similar time frame.     

The relationship between pain tolerance and trait aggression: effects of sex and gender role

The literature on pain and aggression has indicated that pain elicits aggression. However, research has generally examined pain as a situational variable and focused less on the dispositional ability of an individual to tolerate pain. The dearth of research on pain tolerance and aggression appears to contradict the existing theory on the aggression‐eliciting effect of pain, in that studies have found a positive relationship between pain tolerance and aggression. The purpose of this study was to determine whether the relationship between pain tolerance and aggression is moderated by sex and whether the positive relationship could be explained by masculine gender role conformity. A sample of 195 collegiate men and women completed trait measures and a laboratory assessment of pain tolerance. Results indicated that correlations between pain tolerance and trait aggression were significant and positive for men but not women. However, when men's conformity to masculine gender role was controlled for, the relationship between pain tolerance and trait aggression was nil and nonsignificant. Results are discussed in reference to socialization and maintenance of masculine status. Aggr. Behav. 35:422–429, 2009. © 2009 Wiley‐Liss, Inc.     

恐惧的代价：疼痛恐惧、心理忧虑和躯体化对疼痛感知预测作用的比较

首次在无痛群体中比较疼痛恐惧、心理忧虑和躯体化对疼痛感知的预测作用大小及调节和中介关系。以多个同类量表得分的Z分数加和作为三者的因子分,以冷压痛觉测验（CPT）疼痛指标（阈限、耐受性、强度、不愉快度）为目标变量,通过分层回归及调节和中介作用分析,发现疼痛恐惧对疼痛不愉快度的预测作用最强,心理忧虑对疼痛体验（强度、不愉快度）的预测作用被疼痛恐惧完全中介,躯体化只有在高疼痛恐惧条件下才显著负向预测疼痛不愉快度。综上,疼痛恐惧是三因素中预测CPT疼痛体验的主要因素。     

Exposure to physical movement in chronic back pain patients: no evidence for generalization across different movements

This study investigated whether the effects of exposure to one movement generalize towards another dissimilar movement in patients with low back pain. Thirty-nine patients (11 male, 28 female; mean age=43.49 yrs) were requested to perform two movements twice, i.e. bending forward and straight leg raising. During each of the four trials, baseline pain, expected pain and experienced pain were recorded. Analyses revealed that patients initially overpredicted pain, but after exposure the overprediction was readily corrected. This exposure effect did not generalize towards another dissimilar movement. The above pattern of results was only characteristic for patients reporting a high frequency of catastrophic thinking about pain. Low pain catastrophizers did not overpredict pain. The results are discussed in terms of the view that exposure may be better conceived of as the learning of exceptions to a general rule.     

“Everybody feels a broken bone,but only we can feel a broken heart”: Group membership influences the perception of targets' suffering

There is surmounting evidence in the literature demonstrating that social pain (e.g. rejection, humiliation, and isolation) and physical pain (e.g. injury or assault) overlap in personal experiences. The present investigation focuses on second‐hand perceptions of social and physical pain. We argue that judgments of others' pain may vary as a function of group membership. By integrating research on intergroup bias in pain judgment with intergroup attributions of humanity, we predicted that observers tend to underestimate social pain more than physical pain in out‐groups compared with in‐groups. Across two studies that considered different scenarios, we found that Italian participants attributed less severe social pain when considering an out‐group (Chinese and Ecuadorian) than an in‐group member. No such effect was found for physical pain. Overall, the current work suggests an additional way through which people preserve a privileged human status to in‐group members while denying out‐group members' humanness. Copyright © 2012 John Wiley & Sons, Ltd.     

Fibromyalgia in men and women: comparison of the main clinical symptoms

The prevalence of fibromyalgia (FM) in males is much lower than in women. Thus, current knowledge about the syndrome has been developed from research with women. The aim of the present study is to analyze whether FM manifestations differ as a function of sex. Two clinical groups with FM (21 males and 21 women) and a control group of healthy men (n= 21) participated in the study. Several aspects of pain, sleep, fatigue, psychopathology, emotional distress and functional impact of FM were evaluated with an algometer and questionnaires. The clinical groups showed a significantly greater impairment than the control group in all the self-report measures. However, the FM patients only showed significant differences in the sensibility threshold to the pain, which was lower in the women. In addition, the best predictor of the experience of pain in males was sleep quality, and in the women, catastrofying pain. Our results suggest that the most effective therapeutic strategies to control pain may be different for men and women.     

Laterality and modality-specific effects of chronic pain

Previous investigations indicated that thresholds to nonpainful tactile stimuli were elevated in chronic-pain patients when compared with pain-free individuals (Seltzer & Seltzer, 1986; Seltzer et al., 1988). The present study attempted to determine whether thresholds to tactual and visual stimuli also were elevated by chronic pain. Furthermore, lateralization of the pain effect on tactile thresholds was assessed by obtaining thresholds from both left and right arms. A decrease in tactile sensitivity to nonpainful stimuli in chronic-pain patients was confirmed, but laterality of the effect was not demonstrated. Visual thresholds were not significantly affected by chronic pain. The data in the present study, taken together with other data, support the proposition that pain does not affect right hemispheric processes more than left hemispheric processes.     

Laterality and modality-specific effects of chronic pain.

Previous investigations indicated that thresholds to nonpainful tactile stimuli were elevated in chronic-pain patients when compared with pain-free individuals (Seltzer & Seltzer, 1986; Seltzer et al., 1988). The present study attempted to determine whether thresholds to tactual and visual stimuli also were elevated by chronic pain. Furthermore, lateralization of the pain effect on tactile thresholds was assessed by obtaining thresholds from both left and right arms. A decrease in tactile sensitivity to nonpainful stimuli in chronic-pain patients was confirmed, but laterality of the effect was not demonstrated. Visual thresholds were not significantly affected by chronic pain. The data in the present study, taken together with other data, support the proposition that pain does not affect right hemispheric processes more than left hemispheric processes.     

医学生疼痛共情的认知过程特征：来自ERP的证据

以往研究发现临床医生的疼痛共情显著低于常人,表现为前者感知他人疼痛时会出现早期情绪分享和晚期情绪调节的相对抑制。而处于职前培养期的医学生是否存在相似问题,其疼痛共情又是否会受到重复暴露的影响,目前并不清楚。为此,本研究采用ERP技术比较了医学与非医学专业大学生疼痛共情的认知过程,并通过前后测设计检验了重复暴露对二者疼痛共情的影响。行为结果发现两组被试的主观疼痛判断都出现了疼痛共情效应,但未出现组别差异,也未发现重复暴露的影响。但ERP结果显示,医学生的疼痛共情过程显著区别于非医学生。他们虽表现出早期情绪分享成分N1的抑制效应,但LPP反映的晚期认知加工却显著增强,且上述两阶段加工均未受到重复暴露的显著影响。研究表明：（1）医学学习能够抑制疼痛共情的早期情绪分享,但医学生仍可通过更多晚期认知资源投入来维持其疼痛共情水平。（2）医学生的疼痛共情较少受到重复暴露的影响,呈现情绪适应特点。     

Self‐regulatory deficits associated with unpracticed mindfulness strategies for coping with acute pain

Training in mindfulness is a well‐supported therapeutic strategy for pain conditions, though short‐term mindfulness training for acute pain is not always effective. To explore the possibility that initial attempts at mindfulness in people without previous training may drain self‐regulatory resources, the current study used a student sample (N = 63) to test the hypothesis that brief instruction in mindfulness would lead to reduced pain tolerance on a cold pressor task, compared to more familiar strategies for coping with acute pain. We also investigated whether high heart rate variability (HRV), a physiological indicator of self‐regulatory capacity, would predict pain tolerance. Higher HRV predicted greater pain tolerance only in the control group, suggesting that applying unfamiliar mindfulness strategies while attempting to tolerate pain more rapidly sapped self‐regulatory strength.