Increased pain sensitivity and pain-related anxiety in individuals with autism.
Increased pain sensitivity and pain-related anxiety in individuals with autism.
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DOI：
10.1097/pr9.0000000000000861
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发表时间：
2020-11
期刊：
影响因子：
4.8
通讯作者：
Cascio CJ
中科院分区：
文献类型：
--
作者：
Failla MD;Gerdes MB;Williams ZJ;Moore DJ;Cascio CJ
补充数字内容在文本中可用。在言语型自闭症成人中，疼痛相关焦虑与不同持续时间的热痛刺激的疼痛敏感性增加有关。患有自闭症谱系障碍（ASD）的个体通常表现出疼痛反应的差异。这种改变的反应可能与ASD相关的社会沟通困难，感觉差异或疼痛刺激的处理改变有关。以前的神经影像学研究表明，改变疼痛评估可能有助于ASD患者的疼痛相关焦虑。我们假设，与通常发展中的对照组相比，ASD患者会报告疼痛敏感性增加，并支持更多与疼痛相关的焦虑。我们招募了43名成年人（ASD，n = 24;典型发展中，n = 19）进行3项热痛任务（应用于小腿）。我们使用极限方法测量热痛阈值，疼痛评级曲线（40至48°C之间的7个温度，5秒，每次5次试验），以及交替低（42°C）和高（46°C）温度的持续热痛任务（21秒，每次6次试验）。通过自我报告评估疼痛相关焦虑、疼痛恐惧、情境性疼痛灾难化、抑郁症状和自闭症相关社交的个体差异。疼痛阈值无组间差异。对于阈上任务，ASD组的平均疼痛评分在疼痛评分曲线和持续热痛任务中均较高，但ASD组的反应更为多样。ASD组的疼痛焦虑（PASS-Total）和疼痛相关恐惧（FOP-III-Total）较高，且与疼痛评分呈正相关。我们的研究结果表明，感觉和认知经验的疼痛加剧，互动与成人ASD。未来的研究需要评估疼痛相关焦虑对寻求治疗和疼痛行为的影响，因为ASD患者的疼痛相关焦虑水平较高。
Supplemental Digital Content is Available in the Text. In verbal adults with autism, pain-related anxiety was associated with increased pain sensitivity across different durations of heat pain stimuli. 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. We hypothesized that individuals with ASD would report increased pain sensitivity and endorse more pain-related anxiety, compared to typically developing controls. 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. 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. 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.