Traumatic Life Experience and Sensitivity to Laboratory-Controlled Pain Stimuli: A Meta-Analysis

Abstract

Psychological trauma often co-occurs with pain. This relationship has been explored using measures designed to assess pain sensitivity in controlled, laboratory settings; however, findings and posited explanatory mechanisms are wide-ranging. This meta-analysis examines all existing literature that has assessed the relationship between psychological trauma (e.g., car accidents, sexual assault, childhood abuse, neglect) and laboratory pain via quantitative sensory testing (QST) methods (e.g. algometer test for pressure pain threshold, cold pressor test for cold pain threshold). The goals of this review include evaluating the direction of the relationship between psychological trauma and pain sensitivity, as well as exploring potential moderators that may elucidate contributing mechanisms. Following literature and data extraction, analyses were conducted with 53 samples within 48 studies in which there were sufficient data to calculate effect sizes (k = 142) related to psychological trauma and pain sensitivity as measured by QST. Using a random effects correlated weights model with robust variance estimation, an estimated effect size of g = 0.22 (p = 0.002) suggests a small but notable effect of psychological trauma on laboratory-controlled pain sensitivity across prior work. Upon examination of mechanistic moderators, this relationship appears driven by QST measures that tap into pain detection (g = 0.24, p = 0.02) and central sensitization (g = 0.24, p = 0.04); however, models for moderation by pain severity (g = 0.15, p = 0.14) and inhibitory processes (g = 0.30, p = 0.21) were not significant.