Attitude Affects How People Cope With Pain

A new study has found that a feeling of control helps reduce pain, and has implications for how patients with persistent pain cope with what is often a debilitating condition.

Researchers from the Wellcome Trust Centre for Neuroimaging at University College London (UCL, UK) investigated how people cope with pain. In the first stage, volunteers were given an electric stimulus to the backs of their hands and told that they could stop the pain at any point. In the second stage, they were told that the decision to stop the pain was out of their control and could only be stopped by a person or computer outside the room.

Using one of the center's functional magnetic resonance imaging (fMRI) scanners, the researchers were able to show that a number of areas of the brain were activated according to whether the volunteer felt in control of the pain. Most important was the anterolateral prefrontal cortex, which is associated with successful coping with feelings of anxiety.

The researchers also analyzed the subjects' outlook on life, examining whether they felt in control of their own lives. They found that while the subjects' outlook did not affect the anterolateral prefrontal cortex when they controlled the stimulus, when they were not able to stop the painful stimulation, subjects with no control expectations were better at activating this brain region than those with a strong control belief. The findings were published in the November 1, 2006, issue of the Journal of Neuroscience.

"Patients with persistent pain report that often it is not the pain itself that makes their situation unbearable, but the fact that there is nothing they can do against it which makes them feel helpless,” said lead author Dr Katja Wiech. "Unfortunately, this feeling of uncontrollability in turn tends to worsen the pain. On the other hand, teaching persistent pain patients psychological coping strategies to handle their pain usually does help reduce its effects.”




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