Objectives: Women with a history of sexual abuse (SA) commonly report greater pain symptoms. It is still unclear whether enhanced pain susceptibility is the result of altered pain processing and response. Therefore, this pilot study aimed to explore pain sensitivity to experimentally induced pain and associated psychology in women with a history of severe SA.
Methods: Twenty-one survivors of severe, long-lasting SA and 21 control women underwent experimentally induced heat pain and completed psychological questionnaires. Pain measures included heat pain thresholds, pain intensity ratings, and pain tolerance in response to contact heat, painful stimulation delivered to the volar forearm. Questionnaires included somatization (Brief Symptom Inventory), personality traits including harm avoidance, novelty seeking, and reward dependence (Cloninger tridimensional personality questionnaire), and levels of dissociation (Dissociative Experiences Scale).
Results: SA women had elevated heat pain thresholds (45.7±2.2°C vs. 43.9±3.1°C; P=0.042) and higher pain intensity ratings (on a 0 to 100 scale: 80.0±26.6 vs. 51.2±27.7; P=0.001). In addition, they had lower tolerability to painful tonic stimulation, greater somatization, and larger harm avoidance scores. Regression analyses showed that higher pain intensity ratings in SA women associated with greater tendency for harm avoidance but not with levels of dissociation.
Discussion: Women with a history of severe SA seem to have a paradoxical pattern of experimental pain response, characterized by both higher pain thresholds and increased pain intensity ratings. This pattern is associated with the personality trait of harm avoidance. Models that might account for these findings are discussed.
*Faculty of Social Welfare and Health Sciences
‡School of Social Work
§Department of Community Mental Health, Faculty of Social Welfare and Health Sciences
♯Institute for the Study of Affective Neuroscience, University of Haifa
∥Multidisciplinary Treatment Center for Victims of Sexual Abuse
¶Multidisciplinary Treatment Center for Victims of Sexual Abuse and Head of the Psychiatric Unit, Bnaiy-Zion Medical Center
†Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
The authors declare no conflict of interest.
Reprints: Michal Granot, PhD, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa 31905 Israel (e-mail: firstname.lastname@example.org).
Received October 13, 2010
Accepted January 31, 2011