How does semantic pain and words condition pain perception? A short communication

Could relationship-based learnt beliefs and expectations contribute to physiological vulnerability of chronic pain? Making a case to consider attachment in pain research

Pain is an interpersonal and inherently social experience. Pain perception and administration of medical treatment all occur in a particular environmental and social context. Early environmental influences, and early learning experiences and interactions, condition the body's response to different threats (like pain), ultimately shaping the underlying neurophysiology. These early interactions and experiences also determine what situations are perceived as threatening, as well as our belief in our own ability to self-manage, and our belief in others to offer support, during perceived threats. These beliefs intrinsically drive the combination of behaviours that emerge in response to perceived threats, including pain. Such behaviours can be categorised into attachment styles. In this interdisciplinary review, we synthesise and summarise evidence from the neurobiological, psychobiological, psychosocial and psychobehavioural fields, to describe how these beliefs are embedded in the brain's prediction models to generate a series of expectations/perceptions around the level of safety/threat in different contexts. As such, these beliefs may predict how one experiences, and responds to, pain; with potentially significant implications for the development and management of chronic pain. Little attention has been directed to the effect of adult attachment style on pain in research studies and in the clinical setting. Using interdisciplinary evidence, we argue why we think this interaction merits further consideration and research. PERSPECTIVE: This review explores the influence of attachment styles on pain perception, suggesting a link between social connections and chronic pain development. It aligns with recent calls to emphasise the social context in pain research and advocates for increased focus on adult attachment styles in research and clinical practice.

How the inner repetition of a desired perception changes actual tactile perception

Autosuggestion is a cognitive process where the inner repetition of a thought actively influences one's own perceptual state. In spite of its potential benefits for medical interventions, this technique has gained little scientific attention so far. Here, we took advantage of the known link between intensity and frequency perception in touch ('Békésy effect'). In three separate experiments, participants were asked to modulate the perceived intensity of vibrotactile stimuli at the fingertip through the inner reiteration of the thought that this perception feels very strong (Experiment 1, n = 19) or very weak (Experiments 2, n = 38, and 3, n = 20), while they were asked to report the perceived frequency. We show that the task to change the perceived intensity of a tactile stimulus via the inner reiteration of a thought modulates tactile frequency perception. This constitutes the first experimental demonstration that an experimental design that triggers autosuggestion alters participants' tactile perception using a response orthogonal to the suggested variable. We discuss whether this cognitive process could be used to influence the perception of pain in a clinical context.

Effectiveness of Communication Strategies in the Management of Chronic Postsurgical Pain: Protocol for a Systematic Review and Meta-Analysis

Purpose

To describe the details of a systematic review to assess the current evidence about the efficacy of communication strategies on the prevention of chronic postsurgical pain (CPSP).

Methods

The protocol for this systematic review was based on the Cochrane Handbook methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) recommendations. A systematic search of the literature on electronic databases Medline, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science (from the inception to 19 June 2022) was carried out using predefined search terms to identify relevant studies. This review will include randomized clinical trials or observational studies. The search strategy consisted of keywords and index terms related to "clinician", "communication" or "post-surgical pain". Inclusion criteria are as follows: randomized clinical trials or observational studies using a parallel group design that assess the efficacy of communication interventions in patients undergoing surgery and that assess pain and pain-related disability. We considered interventions that included any type of written, verbal, and non-verbal communication in combination with other interventions or without. Control groups may include no communication intervention or another intervention distinctly different. We excluded studies with follow-up duration of less than 3 months, patients aged <18 years, and studies for which no reviewer had language proficiency (eg, Chinese, Korean). Descriptive statistics will be used to summarize quantitative findings. Meta-analysis will only be considered if at least three studies used the same outcome with comparable interventions, as we expect a wide heterogeneity of study population and settings.

Conclusion

This systematic review and meta-analysis will be an important source for clinicians and researchers to understand the influence of communication to prevent CPSP.

Study Registration

This protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO). Registration number: CRD42021241596.

Assessing Pain Research: A Narrative Review of Emerging Pain Methods, Their Technosocial Implications, and Opportunities for Multidisciplinary Approaches

Pain research traverses many disciplines and methodologies. Yet, despite our understanding and field-wide acceptance of the multifactorial essence of pain as a sensory perception, emotional experience, and biopsychosocial condition, pain scientists and practitioners often remain siloed within their domain expertise and associated techniques. The context in which the field finds itself today-with increasing reliance on digital technologies, an on-going pandemic, and continued disparities in pain care-requires new collaborations and different approaches to measuring pain. Here, we review the state-of-the-art in human pain research, summarizing emerging practices and cutting-edge techniques across multiple methods and technologies. For each, we outline foreseeable technosocial considerations, reflecting on implications for standards of care, pain management, research, and societal impact. Through overviewing alternative data sources and varied ways of measuring pain and by reflecting on the concerns, limitations, and challenges facing the field, we hope to create critical dialogues, inspire more collaborations, and foster new ideas for future pain research methods.