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Cited by 18Pain Mechanisms and TreatmentsMusculoskeletal pain and rehabilitationPain Management and Placebo Effect

The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.

When shared pain is not half the pain: enhanced central nervous system processing and verbal reports of pain in the presence of a solicitous spouse

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Nees, Frauke, Ditzen, Beate, Flor, Herta·2022·Pain
DOI 10.1097/j.pain.0000000000002559PMC PMC9393802
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Abstract

The experience of pain and pain behaviors is not only determined by physiological but also psychosocial factors. In this context, the learning history of the individual and specifically operant reinforcement related to spouse responses might play an important role. We investigated the effect of a solicitous and habitually pain-reinforcing spouse for the processing of pain in patients with chronic pain. Using multichannel electroencephalography, pain behaviors, and self-reports of pain, we examined 20 patients with chronic back pain (10 with solicitous and 10 with nonsolicitous spouses) and 10 matched healthy controls. The participants received a series of painful and nonpainful electrical stimuli applied to the site of pain (back) and a control area (finger) in the presence vs absence of the spouse. The global field power of the electroencephalogram with a focus in the frontal region was enhanced in patients with chronic back pain who had a solicitous spouse compared to those with a nonsolicitous spouse and the healthy controls. This was specific for the painful stimulation at the back and occurred only in the presence but not the absence of the spouse. Pain ratings of intensity and unpleasantness were also higher in the patients with solicitous spouses when the spouse was present during painful stimulation. These data suggest that significant other responses indicative of operant reinforcement may have a direct effect on the cerebral processing of pain and related pain perception.

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Crossref · 10.1097/j.pain.0000000000002559

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Figure 1. Overview of the experimental conditions.
Figure 1. Overview of the experimental conditions.CC BY-NC-ND · PubMed Central
Figure 2. Brain reactivity to painful stimulation. The mean (±SEM) global field power ratio for the 3 groups and the 2 sites in the presence vs the absence of the spouse is shown. *P < 0.05.
Figure 2. Brain reactivity to painful stimulation. The mean (±SEM) global field power ratio for the 3 groups and the 2 sites in the presence vs the absence of the spouse is shown. *P < 0.05.CC BY-NC-ND · PubMed Central
Figure 3. Location of the brain activation. This figure shows the activation related to the finger and back stimulation in the primary somatosensory cortex for all subjects (blue) to indicate the site of activation related to the somatosensory stimulation. In red (P < 0.01) and yellow (P < 0.05), the probability map for the painful back stimulation in the presence vs absence of the spouse is displayed. The main difference for the spouse effect is centered in the frontocentral region, far away from the primary somatosensory processing area.
Figure 3. Location of the brain activation. This figure shows the activation related to the finger and back stimulation in the primary somatosensory cortex for all subjects (blue) to indicate the site of activation related to the somatosensory stimulation. In red (P < 0.01) and yellow (P < 0.05), the probability map for the painful back stimulation in the presence vs absence of the spouse is displayed. The main difference for the spouse effect is centered in the frontocentral region, far away from the primary somatosensory processing area.CC BY-NC-ND · PubMed Central
Figure 4. Pain intensity ratings. The figure shows the mean ratings of the painful stimulation for the 3 groups (healthy, patients with a solicitous spouse, and patients with a nonsolicitous spouse) and the 2 conditions (with and without spouse). *P < 0.05.
Figure 4. Pain intensity ratings. The figure shows the mean ratings of the painful stimulation for the 3 groups (healthy, patients with a solicitous spouse, and patients with a nonsolicitous spouse) and the 2 conditions (with and without spouse). *P < 0.05.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Nees, F., Ditzen, B., & Flor, H.
Affiliations
  • Heidelberg University (DE)
  • University Hospital Heidelberg (DE)
Corresponding author
Flor, Herta
ORCID
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-12-15
Volume
163
Issue
9
Pages
e1006-e1012
ISSN
  • 0304-3959 (ISSN-L)
  • 1872-6623
DOI
10.1097/j.pain.0000000000002559
PMC
PMC9393802
OpenAlex
W4200598987
Cited by
18
References
41
Citations by year
2026: 2 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 1
FWCI
1.89
Type
journal article
Language
en
Open access
Licence
Locations
  • Pain (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords
chronic back pain, shared pain, operant reinforcement, pain processing, pain perception, psychosocial factors in pain, pain behavior
MeSH terms
Back Pain, Central Nervous System, Humans, Pain Measurement, Spouses, Chronic Pain

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