Ricerc@Sapienza

CONTROL ID: 2910419
CURRENT CATEGORY: Clinical Practice
CURRENT SUBCATEGORY/DESCRIPTORS: Patient Reported Outcomes: IBD, GERD, Functional Disorders, Other
PRESENTATION TYPE: AGA Institute Oral or Poster
PRESENTER: Rossella Palma
PRESENTER (EMAIL ONLY): rossellapalma89@gmail.com
Abstract

TITLE: INTOLERANCE OF UNCERTAINTY, ANXIETY SENSITIVITY AND HEALTH DISTRESS PREDICTED SELFREPORTED
AND CLINICIAN RATED PAIN DURING UPPER ENDOSCOPY THOUGH PAIN CATASTROPHIZING
AUTHORS (LAST NAME, FIRST NAME): Palma, Rossella1
; Pontone, Stefano1
; Panetta, Cristina1
; La Spina, Gaia3
;
Foglia, Anastasia3
; Raniolo, Marilena1
; Tomai, Manuela2
; Lauriola, Marco3
INSTITUTIONS (ALL):
1. Department of Surgical Sciences, "Sapienza" University of Rome, Rome, Italy.
2. Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Rome, Italy.
3. Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy.
ABSTRACT BODY:
Abstract Body: Background: Endoscopic examination is stressful for patients, producing anxiety and fear, which
increase pain and discomfort. According to the fear-anxiety-avoidance model1
pain perception is affected by
catastrophizing thoughts. Other dispositions influence PC and pain perceptions. Intolerance of Uncertainty (IU) has
been recognized as related to chronic pain and anxiety2
. Anxiety Sensitivity (AS) was associated with PC, chronic
pain and accounted for the relationship of pain with anxious arousal3,4
.
Methods: 39 patients referred for upper endoscopy at the Endoscopy Unit of SAPIENZA University of Rome
participated in this study. Before endoscopy, patients completed the following scales: Anxiety Sensitivity Index (ASI);
Intolerance of Uncertainty Index (IUI); Hospital Anxiety and Depression Scale (HADS), Penn State Worry
Questionnaire (WQ). During endoscopy pain was rated by the Pain Assessment in Advanced Dementia Scale
(PAINAD). After endoscopy, patients reported about pain during the procedure (SR-PAIN). The Pain Catastrophizing
Scale (PCS) was also administered to assesses patient’s aptitude for catastrophic pain. Pain ratings were blinded as
to psychological test results. The study was approved by the local ethical committee.
Results: A non parametric mediation model for small samples (PLS-SEM, Fig. 1) was fitted to the data (R2
= .57 and
.25 for SR-Pain and PAINAD, respectively). IU was associated with WQ, AS, and HADS. In turn, both AS and HADS
predicted PC. In turn, PC was associated with SR-PAIN and with PAINAD. Indirect effects of IU on SR-PAIN and
PAINAD were both significant. HADS but not WQ predicted SR-PAIN. AS was predictive of both pain variables and
mediated the effect of IU (Tab. 1).
Conclusion: IU affected pain and discomfort through increasing anxiety sensitivity, health distress, and pain
catastrophizing. This model was consistent with the fear-anxiety-avoidance model1
and with recent evidence showing
that affective dispositions affect one’s experience of pain2–4. This is the first study showing a relation between IU and
AS with painduring a medical procedure.
1. Asmundson G, Norton P, Vlaeyen J. Fear-avoidance models of chronic pain: An overview. In: Press OU, ed.
Understanding and Treating Fear of Pain. ; 2004:26-43.
2. Fischerauer SF, Talaei-Khoei M, Vissers FL, et al. Pain anxiety differentially mediates the association of pain
intensity with function depending on level of intolerance of uncertainty. J Psychiatr Res. 2018;97(0):30-37.
3. Ramírez-Maestre C, Esteve R, Ruiz-Párraga G, et al. The Key Role of Pain Catastrophizing in the Disability of
Patients with Acute Back Pain. Int J Behav Med. 2017;24(2):239-248.
4. Zvolensky MJ, Bakhshaie J, Paulus DJ, et al. Exploring the Mechanism Underlying the Association Between Pain
Intensity and Mental Health Among Latinos. J Nerv Ment Dis. 2017;205(4):300-307.
TABLE:
Note: The PDF table bel