Relationship of Intersession Variation in Negative Pain-Related Affect and Responses to Thermally-Evoked Pain

The purpose of this study was to determine whether session-specific measures of negative pain-related affect would account for longitudinal variability in the ratings of the evoked thermal pain. Pain-free subjects rated pain evoked on the posterior leg using thermal stimuli of 45 degrees, 47 degrees, 49 degrees, and 51 degrees C on 3 occasions, each separated by 2 weeks. Session-specific negative pain-related affect measures were also collected. Ratings of pain decreased significantly with repeated testing, demonstrating a systematic change in rating from the first to second sessions that ranged from a mean of 5.3 at 47 degrees C to 9.1 at 49 degrees C. In addition, large random variation occurred across all sessions, resulting in minimal detectable change ranging from 14 to 27. The least variability occurred when a mean rating of the 4 temperatures was used. Session-specific measures of pain-related affect decreased with repeated testing; however, the significant between-subject variability in both rating of pain and pain-related affect were not related to each other. No associations were identified between psychological measures and variability in rating of evoked pain. Future studies of the variability in ratings should consider other factors such as attentional focus. Perspective: The individual variability in thermal rating was not explained by individual variation in session-specific measures of negative pain-related affect. The results of this study support the use of repeated baseline measures of thermal stimuli when feasible. When this is not possible, the variability in ratings of thermal stimuli over multiple sessions is reduced when the mean of multiple temperatures is used. (C) 2010 by the American Pain Society