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Affect Balance Style, Experimental Pain Sensitivity, and Pain-related Responses

Sibille, Kimberly T. PhD*; Kindler, Lindsay L. PhD; Glover, Toni L. MSN*; Staud, Roland MD; Riley, Joseph L. III PhD*; Fillingim, Roger B. PhD*,§

The Clinical Journal of Pain: June 2012 - Volume 28 - Issue 5 - p 410–417
doi: 10.1097/AJP.0b013e3182324799
Original Articles

Objectives: Affect is neurobiologically based, influences emotions, contributes to temperamental characteristics, and can be evaluated from both state and trait perspectives. Associations between state-related positive affect (PA), negative affect (NA), and chronic pain have been investigated. However, little is known about the relationship between trait affect patterns and pain-related experiences. Affect balance style (ABS) provides a framework to assess the combined contribution of trait PA and NA. Psychological factors and experimental pain sensitivity are indicated as predictors of chronic pain onset. The current study investigated the relationship between ABS, pain sensitivity, and pain-related measures in healthy adults.

Methods: Participants (n=372) completed quantitative sensory testing, pain-related questionnaires, and the Positive and Negative Affect Scale. ABS groups were categorized as Healthy (high PA, low NA), Low (low PA, low NA), Depressive (low PA, high NA), and Reactive (high PA, high NA). Z-scores were computed for 3 experimental pain measures: ischemic, pressure, and heat.

Results: ABS groups significantly differed on ischemic pain sensitivity and pain-related measures. Specifically, the Healthy group demonstrated lower ischemic pain sensitivity compared with the Reactive group (P=0.02); the Depressive and Reactive groups endorsed higher somatic symptoms compared with the Healthy group (P<0.02); the Low and Depressive groups reported more physical stimuli sensitivity than the Healthy group (P<0.02); and the Reactive group indicated more passive coping strategies then the Low and Healthy groups (P=0.001).

Discussion: Findings from the study suggest that among healthy adults, trait affect patterns are associated with ischemic experimental pain sensitivity and other pain-related measures.

*Community Dentistry and Behavioral Science, College of Dentistry

College of Medicine, University of Florida

§North Florida/South Georgia Veterans Health System, Gainesville, FL

School of Nursing, Oregon Health & Science University, Portland, OR

This work was supported by NIH/NINDS grant NS041670, NINDS training grant NS045551, CTSA grant RR029890, and the North Florida/South Georgia Veterans Health System, Gainesville, FL. Roger Fillingim, PhD, is a stockholder in Algynomics. The authors declare no conflict of interest. A portion of this work was presented at the 2010 American Pain Society Annual Scientific Meeting.68

Reprints: Kimberly Sibille, PhD, Community Dentistry and Behavioral Science, University of Florida, P.O. Box 103628, Gainesville, FL 32610-3628 (e-mail:

Received April 1, 2011

Accepted August 10, 2011

© 2012 Lippincott Williams & Wilkins, Inc.