Journal
PAIN REPORTS
Volume 5, Issue 6, Pages -Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PR9.0000000000000861
Keywords
Pain; Autism; Anxiety; Psychophysics
Categories
Funding
- National Institutes of Mental Health [1R01MH102272, T32-MH18921, TL1TR002244-03]
- National Institute of General Medical Sciences [T32-GM007347]
- Autism Science Foundation [2082]
- Vanderbilt Kennedy Center Treatment and Research Institute for Autism Spectrum Disorders [NICHD U54HD083211]
- Vanderbilt Institute for Clinical and Translational Research (NCATS/NIH) [UL1 TR000445]
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Introduction:Individuals with autism spectrum disorder (ASD) often exhibit differences in pain responsivity. This altered responsivity could be related to ASD-related social communication difficulties, sensory differences, or altered processing of pain stimuli. Previous neuroimaging work suggests altered pain evaluation could contribute to pain-related anxiety in ASD.Objectives:We hypothesized that individuals with ASD would report increased pain sensitivity and endorse more pain-related anxiety, compared to typically developing controls.Methods:We recruited 43 adults (ASD, n = 24; typically developing, n = 19) for 3 heat pain tasks (applied to the calf). We measured heat pain thresholds using a method of limits approach, a pain-rating curve (7 temperatures between 40 and 48 degrees C, 5 seconds, 5 trials each), and a sustained heat pain task with alternating low (42 degrees C) and high (46 degrees C) temperatures (21 seconds, 6 trials each). Individual differences in pain-related anxiety, fear of pain, situational pain catastrophizing, depressive symptoms, and autism-related social communication were assessed by self-report.Results:There were no group differences in pain thresholds. For suprathreshold tasks, mean pain ratings were higher in ASD across both the pain-rating curve and the sustained heat pain tasks, but responses in the ASD group were more varied. Pain anxiety (PASS-Total) and pain-related fear (FOP-III-Total) were higher in the ASD group and were positively associated with pain ratings.Conclusions:Our results suggest that both sensory and cognitive experiences of pain are heightened and interact reciprocally in adults with ASD. Future studies are needed to evaluate the impact of pain-related anxiety on treatment-seeking and pain behaviors, given higher levels of pain-related anxiety in ASD.
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