Researchers at the University of Alabama at Birmingham (UAB) have found that a person’s level of optimism — the general expectation of positive outcomes in his or her future — indirectly affected how much pain they reported in a study of people suffering from osteoarthritic (OA) disease. The study was recently published online in The Journal of Pain.
“Past research has shown that optimists rate their pain as less severe, but it could not adequately explain why this occurred,” said Burel Goodin, Ph.D., primary investigator of the study and director of the UAB Biobehavioral Pain Research Lab. “We found that optimism indirectly affects pain reports through pain catastrophizing, an exaggerated negative response to actual or anticipated pain.”
Goodin, with a team of researchers from UAB and the University of Florida, studied 140 people between 45 and 85 years of age suffering from knee OA. The investigators used quantitative sensory testing, an approach to pain sensitivity assessment that consists of measuring subjects’ responses to various standardized methods of painful stimulation, such as heat and pressure.
The study showed that knee OA patients who demonstrated the greatest levels of optimism tended to engage in less pain catastrophizing in anticipation of a painful stimulus. In turn, less pain catastrophizing predicted less severe pain reports in response to quantitative sensory testing.
|The study showed that knee OA patients who demonstrated the greatest levels of optimism tended to engage in less pain catastrophizing in anticipation of a painful stimulus.|
Goodin, a clinical health psychologist who specializes in pain-related behavioral medicine, often sees varying degrees of optimism and pessimism in clinical settings. He said even when people have a chronic health condition, their physical and mental well-being often benefits from keeping an optimistic outlook.
“If we can actually target optimism and steer people towards that disposition, then we might be able to improve their outlook on future pain, and they might be more compliant with doctor’s orders or adhere to their treatments,” said Goodin, an assistant professor in the UAB Department of Psychology.
Cheryl McCullumsmith, M.D., Ph.D., director of the UAB Division of Hospital Psychiatry, said it is possible to teach optimism using experiential methods and treatment.
“While people may have a predisposition to a generally positive outlook or a negative outlook, several proven psychotherapy techniques that focus on shifting one’s negative thoughts to positive ones result in improvement in depression,” said McCullumsmith.
Goodin would like clinicians to start considering personal outlook. He said this could potentially help tailor treatments and decrease health-care costs by allocating treatments to those most in need. For instance, chronic pain patients with greater optimism may have fewer problems with pain catastrophizing, as suggested in this study, and require less treatment focused on this maladaptive pain response. Conversely, patients with less optimism may require additional treatment and assistance in order to effectively manage their pain catastrophizing.