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Increased pain sensitivity and pain-related anxiety in individuals with autism

Failla, MD, Gerdes, MB, Williams, ZJ, Moore, DJ and Cascio, CJ (2020) Increased pain sensitivity and pain-related anxiety in individuals with autism. PAIN Reports, 5 (6). ISSN 2471-2531

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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°C, 5 seconds, 5 trials each), and a sustained heat pain task with alternating low (42°C) and high (46°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.

Item Type: Article
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Psychology (from Sep 2019)
Publisher: Lippincott, Williams & Wilkins
Date Deposited: 26 Mar 2021 10:27
Last Modified: 04 Sep 2021 05:42
DOI or ID number: 10.1097/pr9.0000000000000861
URI: https://researchonline.ljmu.ac.uk/id/eprint/14688
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