European journal of pain : EJP
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There is some evidence that stress-induced cortisol increase leads to a decrease in pain, while lowering cortisol levels enhances pain sensitivity, but no study has yet investigated both pharmacological enhancement and reduction of cortisol levels in the same individuals. ⋯ These findings suggest that short-term variations of cortisol do not influence pain sensitivity whereas, in general, high levels of cortisol are associated with increased pain sensitivity, at least for weak to moderate stimuli.
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The face as a visual stimulus is a reliable source of information for judging the pain experienced by others. Until now, most studies investigating the facial expression of pain have used a descriptive method (i.e. Facial Action Coding System). However, the facial features that are relevant for the observer in the identification of the expression of pain remain largely unknown despite the strong medical impact that misjudging pain can have on patients' well-being. ⋯ Based on a recent study suggesting that this area codes for the affective dimension of pain, we propose that the visual system has evolved to focus primarily on the facial cues that signal the aversiveness of pain, consistent with the social role of facial expressions in the communication of potential threats.
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The vigilance-(attentional) avoidance hypothesis (VAH) developed for explaining phobic reactions describes an early attentional bias towards a feared stimulus followed by attentional avoidance of this stimulus. Such a pattern of attentional shifts might also be found when processing of pain-related stimuli is required. The purpose of the present study was to test the VAH for pain-associated stimuli, i.e., faces displaying pain, using the method of eye-tracking in a pain-free sample. ⋯ We assume that initial vigilance for pain-associated stimuli might reflect an adaptive reaction to detect a potentially harmful stimulus. Subsequently, the pain-associated stimulus might be less attended for the purpose of mood regulation when all clear is given in this situation.
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Anxiety, in particular pain-related anxiety, plays an important role in explaining the severity of pain complaints and pain-related disability in both adults and children with chronic pain. The fear-avoidance model (FAM) describes how pain-related anxiety plays a critical role in the maintenance of pain-avoidance behaviour, which in turn influences pain-related disability. However, the FAM does not take into account broader aspects of adolescence, such as social functioning, which could be negatively impacted by anxiety. In addition, most studies examining the role of anxiety in pain have used small convenience or clinical samples. By using a large UK epidemiological database, this study investigated the associations between pain-related anxiety, disability and judgements of social impairment. ⋯ Pain-related anxiety was associated with greater pain-related disability and impaired social functioning. Social functioning should be explored as an integral part of fear-avoidance models of adolescent chronic pain.
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Chronic pain in the neck and low back is highly prevalent. Although heritable components have been identified, knowledge about generational transmission of spinal pain between parents and their adult offspring is sparse. ⋯ Parental chronic spinal pain was consistently associated with increased occurrence of chronic spinal pain in their adult offspring, and this association was particularly strong for multilevel spinal pain.