Painfully Sensitive: How Sensory Processing Sensitivity Affects Healthy Adolescents' Perception of Pain

Overview

Journal J Pain Res

Publisher Dove Medical Press

Date 2025 Feb 20

PMID 39975531

Authors

Jana Hochreuter

Susanne Wehrli

Cosima Locher

Francesca Lionetti

Joe Kossowsky

Michael Pluess

Helen Koechlin

Affiliations

Soon will be listed here.

Abstract

Objective: Sensory processing sensitivity (SPS) describes a common trait characterized by lower sensory threshold, depth of processing, and ease of overstimulation. Low sensory threshold is also potentially important in the context of pain. To date, the relationship between SPS and pain perception has not been investigated, particularly in adolescents. This randomized experimental study aimed to explore whether SPS was associated with pain threshold and tolerance in healthy adolescents. Further, we examined differences in pain perception following positive, negative, or neutral mood induction.

Methods: A total of 100 healthy adolescents aged 16 to 19 years were recruited through schools and online advertisement. Participants completed psychosocial questionnaires and underwent a randomized mood induction (positive, negative, or neutral). Pain levels (in °C) and self-reported pain tolerance and threshold were assessed by an experimental heat pain paradigm. Regression models were applied to determine effects of mood induction on pain perception, while multiple analyses of variance (ANOVAs) were computed to compare sensitivity across groups.

Results: The mood induction significantly influenced self-reported pain ratings, demonstrating a positive interaction coefficient for the positive mood condition ( = 1.140, < 0.01). ANOVAs revealed significant differences between sensitivity groups for baseline scores of pain threshold (F = 5.009, p < 0.01) and tolerance (F = 3.193, < 0.05) (F = 7.431, p < 0.001).

Conclusion: Our findings reveal that highly sensitive adolescents had the lowest ratings of measured pain tolerance and threshold measures at baseline, suggesting heightened sensitivity to pain. This highlights the importance of considering sensory processing sensitivity in pain research, particularly in adolescent populations.

References

Lionetti F, Aron A, Aron E, Burns G, Jagiellowicz J, Pluess M . Dandelions, tulips and orchids: evidence for the existence of low-sensitive, medium-sensitive and high-sensitive individuals. Transl Psychiatry. 2018; 8(1):24. PMC: 5802697. DOI: 10.1038/s41398-017-0090-6. View

Sethna N, Meier P, Zurakowski D, Berde C . Cutaneous sensory abnormalities in children and adolescents with complex regional pain syndromes. Pain. 2007; 131(1-2):153-61. DOI: 10.1016/j.pain.2006.12.028. View

Tavakol M, Dennick R . Making sense of Cronbach's alpha. Int J Med Educ. 2016; 2:53-55. PMC: 4205511. DOI: 10.5116/ijme.4dfb.8dfd. View

Gatchel R, Peng Y, Peters M, Fuchs P, Turk D . The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007; 133(4):581-624. DOI: 10.1037/0033-2909.133.4.581. View

Stensen K, Lydersen S . Internal consistency: from alpha to omega?. Tidsskr Nor Laegeforen. 2022; 142(12). DOI: 10.4045/tidsskr.22.0112. View

Parker G . The Parental Bonding Instrument. A decade of research. Soc Psychiatry Psychiatr Epidemiol. 1990; 25(6):281-2. DOI: 10.1007/BF00782881. View

Birnie K, Caes L, Wilson A, Williams S, Chambers C . A practical guide and perspectives on the use of experimental pain modalities with children and adolescents. Pain Manag. 2014; 4(2):97-111. PMC: 4110966. DOI: 10.2217/pmt.13.72. View

Wilson A, Holley A, Palermo T . Applications of laboratory pain methodologies in research with children and adolescents: emerging research trends. Pain. 2013; 154(8):1166-1169. PMC: 3733376. DOI: 10.1016/j.pain.2013.04.014. View

Heider D, Matschinger H, Bernert S, Vilagut G, Martinez-Alonso M, Dietrich S . Empirical evidence for an invariant three-factor structure of the Parental Bonding Instrument in six European countries. Psychiatry Res. 2005; 135(3):237-47. DOI: 10.1016/j.psychres.2005.05.002. View

10.

Pluess M, Assary E, Lionetti F, Lester K, Krapohl E, Aron E . Environmental sensitivity in children: Development of the Highly Sensitive Child Scale and identification of sensitivity groups. Dev Psychol. 2017; 54(1):51-70. DOI: 10.1037/dev0000406. View

11.

Acevedo B, Aron E, Aron A, Sangster M, Collins N, Brown L . The highly sensitive brain: an fMRI study of sensory processing sensitivity and response to others' emotions. Brain Behav. 2014; 4(4):580-94. PMC: 4086365. DOI: 10.1002/brb3.242. View

12.

Smetana J, Campione-Barr N, Metzger A . Adolescent development in interpersonal and societal contexts. Annu Rev Psychol. 2005; 57:255-84. DOI: 10.1146/annurev.psych.57.102904.190124. View

13.

Koechlin H, Donado C, Locher C, Kossowsky J, Lionetti F, Pluess M . Sensory processing sensitivity in adolescents reporting chronic pain: an exploratory study. Pain Rep. 2023; 8(1):e1053. PMC: 9829261. DOI: 10.1097/PR9.0000000000001053. View

14.

Grasaas E, Mikkelsen H, Haraldstad K, Helseth S, Smastuen M, Skarstein S . Pain in Adolescence: Maternal and Paternal Factors Affecting Adolescents' Pain in Norway-A Cross-Sectional Study. Children (Basel). 2023; 10(12). PMC: 10741755. DOI: 10.3390/children10121915. View

15.

Locher C, Koechlin H, Zion S, Werner C, Pine D, Kirsch I . Efficacy and Safety of Selective Serotonin Reuptake Inhibitors, Serotonin-Norepinephrine Reuptake Inhibitors, and Placebo for Common Psychiatric Disorders Among Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2017; 74(10):1011-1020. PMC: 5667359. DOI: 10.1001/jamapsychiatry.2017.2432. View

16.

Teles A, Ocay D, Shebreen A, Tice A, Saran N, Ouellet J . Evidence of impaired pain modulation in adolescents with idiopathic scoliosis and chronic back pain. Spine J. 2018; 19(4):677-686. DOI: 10.1016/j.spinee.2018.10.009. View

17.

Sih A, Bell A . Insights for Behavioral Ecology from Behavioral Syndromes. Adv Study Behav. 2014; 38:227-281. PMC: 4075144. DOI: 10.1016/S0065-3454(08)00005-3. View

18.

Zaman J, Van Oudenhove L, Vlaeyen J . Uncertainty in a context of pain: disliked but also more painful?. Pain. 2020; 162(4):995-998. DOI: 10.1097/j.pain.0000000000002106. View

19.

Treede R, Rief W, Barke A, Aziz Q, Bennett M, Benoliel R . A classification of chronic pain for ICD-11. Pain. 2015; 156(6):1003-1007. PMC: 4450869. DOI: 10.1097/j.pain.0000000000000160. View

20.

Gruhn D, Scheibe S . Age-related differences in valence and arousal ratings of pictures from the International Affective Picture System (IAPS): do ratings become more extreme with age?. Behav Res Methods. 2008; 40(2):512-21. DOI: 10.3758/brm.40.2.512. View