Relationship of subjective helplessness and pain perception after electric skin stimuli

Abstract

Objective and subjective controllability of painful stimuli are important factors in pain perception. The present study investigated direct and indirect effects of uncontrollability on perceived pain intensity in humans. Forty-eight healthy male volunteers participated in a laboratory experiment using a reaction time paradigm to induce controllable or uncontrollable feedback conditions in two randomly selected groups. Under controllable conditions, unpleasant electric skin shocks were applied, only when the actual time exceeded an individual threshold; under uncontrollable conditions, skin shocks were applied randomly using a yoked control design. Subjective helplessness, perceived pain intensity and additional psychological variables were assessed prior to and after the experiment. The results indicate a strong relationship only between the individually perceived helplessness and pain perception (r=+0.62, p<0.0001) independent of objective stimulus controllability. Neither mood states nor personality traits yielded a significant correlation with perceived pain. After uncontrollable shock exposure, subjects described themselves as slightly more helpless and significantly more activated, anxious, and angry (p<0.05). A path analysis revealed only a modest indirect effect of objective uncontrollability on perceived pain intensity, and a strong independent impact of subjective helplessness. The results underline the importance of subjective feelings of helplessness in pain perception, which should be taken into account in further studies. Copyright © 2000 John Wiley & Sons, Ltd.