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The sensory and affective components of pain: are they differentially modifiable dimensions or inseparable aspects of a unitary experience? A systematic review

British journal of anaesthesia : BJA, 2019-08, Vol.123 (2), p.e263-e272 [Peer Reviewed Journal]

2019 British Journal of Anaesthesia ;Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved. ;2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved. 2019 British Journal of Anaesthesia ;ISSN: 0007-0912 ;EISSN: 1471-6771 ;DOI: 10.1016/j.bja.2019.03.033 ;PMID: 31053232

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  • Title:
    The sensory and affective components of pain: are they differentially modifiable dimensions or inseparable aspects of a unitary experience? A systematic review
  • Author: Talbot, K. ; Madden, V.J. ; Jones, S.L. ; Moseley, G.L.
  • Subjects: Affect ; Biopsychosocial Factor ; cognition ; Humans ; hypnosis ; imagery ; Mind-Body Therapies - methods ; Pain - physiopathology ; Pain - psychology ; pain measurement ; Pain Measurement - methods ; Pain Perception
  • Is Part Of: British journal of anaesthesia : BJA, 2019-08, Vol.123 (2), p.e263-e272
  • Description: Pain is recognised to have both a sensory dimension (intensity) and an affective dimension (unpleasantness). Pain feels like a single unpleasant bodily experience, but investigations of human pain have long considered these two dimensions of pain to be separable and differentially modifiable. The evidence underpinning this separability and differential modifiability is seldom presented. We aimed to fill this gap by evaluating the current evidence base for whether or not the sensory and affective dimensions of pain can be selectively modulated using cognitive manipulations. A rigorous systematic search, based on a priori search terms and consultation with field experts, yielded 4270 articles. A detailed screening process was based on the following recommendations: (i) evaluation of effectiveness; (ii) examination of methodological rigour, including each study having an a priori intention to cognitively modulate one of the two dimensions of pain; and (iii) sound theoretical reasoning. These were used to ensure that included studies definitively answered the research question. After in-depth critique of all 12 articles that met the inclusion criteria, we found that there is no compelling evidence that the sensory and affective dimensions of pain can be selectively and intentionally modulated using cognitive manipulations in humans. We offer potential explanations for this discrepancy between assumptions and evidence and contend that this finding highlights several important questions for the field, from both the research and clinical perspectives.
  • Publisher: England: Elsevier Ltd
  • Language: English
  • Identifier: ISSN: 0007-0912
    EISSN: 1471-6771
    DOI: 10.1016/j.bja.2019.03.033
    PMID: 31053232
  • Source: GFMER Free Medical Journals
    MEDLINE
    Alma/SFX Local Collection
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