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Bethany L. Kuhn, BS, Shreela T. Palit, BS, Kara L. Kerr, BA, Ellen L. Terry, MA, Jenna L. Delventura, MA, Emily J. Bartley, Phd, Joanna O

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Bethany L. Kuhn, BS, Shreela T. Palit, BS, Kara L. Kerr, BA, Ellen L. Terry, MA, Jenna L. Delventura, MA, Emily J. Bartley, Phd, Joanna O Pain catastrophizing and experimental pain in Native Americans Bethany L. Kuhn, BS, Shreela T. Palit, BS, Kara L. Kerr, BA, Ellen L. Terry, MA, Jenna L. DelVentura, MA, Emily J. Bartley, PhD, Joanna O. Shadlow, PhD, & Jamie L. Rhudy, PhD Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK 74104 Introduction Pain Catastrophizing Scale Data Analysis Pain catastrophizing is a cognitive-emotional coping strategy associated with enhanced pain. Unfortunately, little 13 item self-report measure for use in clinical and non-clinical samples; used for persons with and Multiple regression analysis were conducted for trait and state catastrophizing to predict pain outcomes work has been done to examine catastrophizing and its relationship to pain within ethnically diverse individuals, without pain Group, Trait Catastrophizing and State Catastrophizing were entered into Step 1 including Native Americans. We have found that Native Americans have dampened pain in response to noxious The subscales were rumination, magnification and helplessness Group X Trait interaction or Group X State interaction were entered into Step 2 laboratory stimuli, but it is unclear whether this is related to individual differences in pain catastrophizing. To Internal consistency: alphas for PCS total and subscales range from .66 to .87 address this issue, the present study examined pain catastrophizing and its relationship to laboratory pain Traditional PCS Instructions: “Please indicate the degree to which you have these thoughts and outcomes such as nociceptive flexion reflex threshold (NFR; a physiological measure of spinal nociception), feelings when you are experiencing pain.” Results: Pain Catastrophizing and Pain Outcomes ischemia pain threshold/tolerance, pain ratings of suprathreshold electric stimuli, electric pain threshold/tolerance, Situation-Specific PCS Instructions: “Thinking back to your experience during the electric stimulations, electric/ischemic sensory and affective pain ratings. please indicate the degree to which you had these thoughts and feelings.” Objective Nociceptive Flexion Reflex (NFR) To examine pain catastrophizing in Native Americans relative to a white, non-Hispanic control group. Biceps femoris EMG sensors Participants Baseline NFR Window Healthy white, non-Hispanic (N = 20) & Native American (N = 22) participants Spinally-mediated withdrawal reflex elicited by Aδ fibers non-Hispanic Whites Native Americans NFR magnitude correlates with pain ratings and NFR threshold (n = 20) (n = 22) correlates with pain threshold *p<.05 M SD Range M SD Range Stimulating electrode over Sex (% female) 35% (n = 7) 36% (n = 8) NFR Threshold: Defined as the stimulus intensity (mA) that reliably State and trait catastrophizing were positively correlated with affective ratings of electric and ischemic stimuli. sural nerve Age (years) 33.60 11.99 19-55 41.14 14.39 18-64 elicits the reflex State catastrophizing was also positively correlated with sensory ratings of electric stimuli. Education (years) 16.18 2.67 12-23 14.25 3.23 5-22 Ischemia Pain Threshold/Tolerance Exclusion Criteria: Results: Pain Catastrophizing and Pain Outcomes <18 years of age 2 min. of hand exercises at 50% maximum Current acute illness grip strength Cardiovascular, neurological, and/or circulatory problems 15 sec. of arm elevation for exsanguination Chronic pain condition (e.g., back pain) Blood pressure cuff inflated to 220 mm/Hg and Recent use of analgesic medication left inflated until participant reached tolerance Current use of anxiolytic and/or hypertensive medication Pain was rated continuously Experimental Procedure Ischemia Pain Threshold/ Tolerance: Threshold was defined as the time (in sec.) when participant rated ischemia pain as painful (rating = 50). Tolerance was defined as the time (in sec.) when participant Informed Consent + Pain Catastrophizing Questionnaire (PCS) rated ischemia pain as maximum tolerable (rating = 100). Group x Catastrophizing interaction was significant Group x Catastrophizing interaction was marginally Ischemic Pain Threshold/Tolerance Testing: (p=.05) significant (p=.07) - Participants completed a set of hand exercises to increase energy demand in the forearm muscles. State catastrophizing had a stronger negative State catastrophizing had a stronger positive - Blood to the forearm was occluded by inflating a blood pressure cuff around their upper arm relationship with electric pain threshold in Native relationship with sensory ratings of ischemia pain in - Pain tolerance was defined as the time (in sec.) from blood occlusion to the point at which the individual Electric Pain Threshold/Tolerance Americans Native Americans reported they could no longer tolerate the ischemic pain. Pain threshold was defined as the time (in sec.) when Numerical Rating Scale (NRS): A single, ascending series of electrical the individual reported the ischemia pain as painful (rating ≥ 50). stimulations were delivered to the sural nerve. Stimulations started at 0 mA Conclusions McGill Pain Questionnaire-SF (MPQ) and increased in 2 mA steps. Pain ratings were made following each In sum, these findings confirm prior research indicating that state catastrophizing is a better predictor of pain Pain Catastrophizing Questionnaire (PCS) stimulation. than trait catastrophizing. NFR Testing Electric Pain Threshold/Tolerance Testing: Catastrophizing is more strongly related to retrospective reports of pain (e.g., affective ratings) than other Electric Pain Threshold/Tolerance: Electric pain threshold was defined as - Single ascending series of electrical stimulations delivered to the sural nerve of the ankle measures (e.g., pain threshold). until pain tolerance was reached (rating = 100). Pain threshold was defined as a rating ≥ 50. the intensity of stimulation (mA) at which point the participant reported pain These findings also suggest there may be ethnic differences in the relationship between catastrophizing and (NRS rating ≥ 50). Electric pain tolerance was defined as the intensity of McGill Pain Questionnaire-SF (MPQ) pain in Native Americans. stimulation (mA) at which point the participant reported the most intense pain Pain Catastrophizing Questionnaire (PCS) imaginable (NRS rating = 100). Mandatory breaks were given after each testing block Funding Support: This work was funded by a Psi Chi Faculty Research grant awarded to Jamie L. Rhudy and Joanna Shadlow. .
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