Vigilance to Painful Laser Stimuli is Associated with Increased State Anxiety and Tense Arousal

Timothy J Meeker; Mark I Saffer; Jodie Frost; Jui-Hong Chien; Roger J Mullins; Sean Cooper; O Joseph Bienvenu; Fred A Lenz

doi:10.2147/JPR.S412782

Vigilance to Painful Laser Stimuli is Associated with Increased State Anxiety and Tense Arousal

J Pain Res. 2023 Dec 4:16:4151-4164. doi: 10.2147/JPR.S412782. eCollection 2023.

Authors

Timothy J Meeker^{1

2}, Mark I Saffer¹, Jodie Frost¹, Jui-Hong Chien¹, Roger J Mullins^{1

2}, Sean Cooper¹, O Joseph Bienvenu³, Fred A Lenz¹

Affiliations

¹ Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA.
² Department of Biology, Morgan State University, Baltimore, MD, USA.
³ Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA.

Abstract

Introduction: Pain is frequently accompanied by enhanced arousal and hypervigilance to painful sensations. Here, we describe our findings in an experimental vigilance task requiring healthy participants to indicate when randomly timed moderately painful stimuli occur in a long train of mildly painful stimuli.

Methods: During a continuous performance task with painful laser stimuli (CPTpain), 18 participants rated pain intensity, unpleasantness, and salience. We tested for a vigilance decrement over time using classical metrics including correct targets (hits), incorrectly identified non-targets (false alarms), hit reaction time, and false alarm reaction time. We measured state anxiety and tense arousal before and after the task.

Results: We found a vigilance decrement across four 12.5-minute blocks of painful laser stimuli in hits [F_3,51=2.91; p=0.043; time block 1>block 4 (t=2.77; p=0.035)]. Both self-report state anxiety (t_paired,17=3.34; p=0.0039) and tense arousal (t_paired,17=3.20; p=0.0053) increased after the task. We found a vigilance decrement during our laser pain vigilance task consistent with vigilance decrements found in other stimulus modalities. Furthermore, state anxiety positively correlated with tense arousal.

Discussion: CPTpain acutely increased tense arousal and state anxiety, consistent with previous results implicating the reciprocal interaction of state anxiety and acute painful sensations and the role of pain in augmenting tense arousal. These results may indicate a psychological process which predisposes the hypervigilant to developing greater acute pain, resulting in positive feedback, greater pain and anxiety.

Keywords: continuous performance task; false alarms; pain; salience; vigilance.

Grants and funding

R01 NS107602/NS/NINDS NIH HHS/United States