Relationships among Eysenck's Extraversion, Rorschach's Erlebnistypus, and Tolerance of Experimental Tonic Pain (Cold Water Pressor Test)

In a group of 42 healthy volunteers the correlations between the concept of Extraversion-Introversion as defined by Eysenck and Erlebnistypus as defined by Rorschach were analysed to relate these with the tolerance of an experimentally induced tonic pain. We conducted an experimental procedure comprising a test and retest. At test the subjects were administered the Rorschach, the Eysenck Personality Inventory, the Cold Water Pressor Test, a nongraduated Visual Analogue Scale, and the Italian version of the McGill Pain Questionnaire. At retest the experimental induction of pain was measured again. At test subjects who scored higher on the EPI Extraversion scale tolerated pain longer and did not modify their performance at retest. Also, the concepts of Extroversion defined by the Rorschach test and by the Extraversion scale of the Eysenck Personality Inventory shared some psychophysiological features of higher tolerance to pain. These personality features did not influence how subjects qualitatively describe the immediate painful experience.

Effects of extraversion and neuroticism on experimental pain, clinical pain, and illness behavior

The effects of 2 personality traits, extraversion and neuroticism, on experimental and clinical pain were characterized in a group of myofascial pain dysfunction (MPD) patients. Extraverts did not differ from introverts in visual analogue scale (VAS) sensory or VAS affective ratings of graded 5-sec nociceptive temperature stimuli (43-51 degrees C) nor in VAS sensory-VAS affective relationships related to their clinical pain. However, high extravert patients scored lower on affective inhibition (Pilowsky Illness Behavior Questionnaire; IBQ) compared to low extravert patients. This result is consistent with previous suggestions that extraverts inhibit overt expressions of suffering less than do introverts. High neurotic patients did not differ from low neurotic patients in their VAS sensory ratings of either experimental or clinical pain. Their VAS affective ratings of both types of pain were marginally higher as compared to low neurotic patients. As hypothesized, high neurotic score patients gave higher VAS ratings of emotions related to suffering and scored higher on items related to affective disturbance on the IBQ as compared to low neurotic score patients. Overall, the results indicate that the personality traits of neither extraversion nor neuroticism affect sensory mechanisms of nociceptive processing but appear to exert their influence by means of cognitive processes related to the ways in which people constitute the meanings and implications of pain.

Pain and pain control in children

Focused research on pain and pain control in children has developed primarily in the last 10 years and even now is woefully inadequate in relation to the magnitude of the problem. The available research, inferences from the adult literature, and anecdotal information all indicate the elusive nature of pain. Pain is not solely a fixed neurophysiologic response to a noxious stimulus but a product of the interaction of many variables such as age, cognitive set, personality, ethnic background, and emotional state. These factors exert a tremendous influence on the suffering which surrounds the pain message. Technology exists at present to eliminate or substantially reduce pain in almost all cases. There remains, however, a tendency, which is even more pronounced with respect to children, to underestimate or ignore pain. In an overall approach to pain in children, the following points should be considered: A high index of suspicion is necessary to determine if children are experiencing pain since they may have difficulty verbalizing their discomfort. In infants, physiologic variables should be considered (increased heart rate, palmar sweating, increased respiratory rate), and in preschoolers, time should be taken to ascertain that the child actually understands the word "pain" if it is used in questioning them. Some method of continuous monitoring, such as a visual analogue scan, should be considered as part of the treatment plan. Adequate analgesia should be provided. The appropriate dose should be administered at the appropriate pharmacokinetic time. Too little medication may cause obsessive attention to medication-related issues. Too much medication may cause sedation and lack of mental clarity, which is often anxiety-producing for both the parents and the child. The usefulness of p.r.n. medication has been seriously questioned and a time-contingent as opposed to pain-contingent strategy should be applied. Fears of addiction are generally unwarranted. Adjunctive medication may increase the value of offered narcotics and counteract some of their side effects. Although this monograph has focused more attention on pharmacologic than on nonpharmacologic approaches to pain, this is merely a reflection of available data and not necessarily of relative importance. The importance of distraction from pain by nursing, medical, or child life personnel using play techniques cannot be overestimated. Every attempt should be made to relax the child by using creative strategies. Preparation of the child for procedures is often helpful as some of the fear of the unknown is eliminated.(ABSTRACT TRUNCATED AT 400 WORDS)

Recurrent pains in children: an overview and an approach

This article provides a broad overview of current thinking about pain and then outlines an approach to a unique category of pain, recurrent pains of obscure origin.