New evidence of a ‘pain personality’ found

Australian researchers say they have identified new evidence of a “pain personality” following a review of 120 years of research. The review published in the Scandinavian Journal of Pain identified two common personality traits in people living with chronic pain; higher levels of harm-avoidance and lower levels of self-directedness. High harm avoidance refers to a tendency to be fearful, pessimistic, sensitive to criticism, and requiring high levels of re-assurance. Low self-directedness often manifests as difficulty with defining and setting meaningful goals, low motivation, and problems with adaptive coping. “Assessing such personality traits may help to address the complexity of chronic pain presentations. For example, it may help to identify and treat sufferers more resistant to treatment, more prone to comorbidity and more vulnerable to entering the vicious cycle of chronic pain, suffering and disability,” the authors wrote. Understanding the relationship between pain and personality is considered a new frontier in understanding the complexity of chronic pain. Senior neuroscientist Dr Sylvia Gustin at Neuroscience Research Australia (NeuRA) says the more they know about the link, the greater the hope of developing drug-free alternatives to treatment. “I have worked for 20 years with people with chronic pain and I would say there is not one medication which decreases your pain to zero,” Dr Gustin told AAP. It’s believed this is because the brain continues to generate pain even after the injury that first caused the acute pain has healed, says Dr Gustin. Previous research at NeuRA using advanced brain imaging technology has shown chronic pain actually changes the brain. “Our work showed people with ongoing chronic pain have subtle anatomical structural and functional biochemical brain changes associated with our personality and emotions,” Dr Gustin said. These brain changes were detected in two areas of the brain; the hypothalamus (the middle of the brain) and the medial prefrontal cortex, which is associated with personality and emotions. “The medial prefrontal cortex has lost its ability to dampen down our worries, our fears and this results in a state of ongoing worry which is then reflected in high levels of harm avoidance,” said Dr Gustin. It’s still not known whether people develop chronic pain because they have a certain personality or the personality is changed because of the chronic pain, acknowledged Dr Gustin. But, she says, there is more evidence to support the later. Researchers at NeuRA are now in the process of a clinical trial using a technique known as Neural Feedback to treat chronic pain sufferers. The trial – led by Dr Gustin and her colleague Dr James McAuley – involves participants wearing a headset with electrodes to measure their brain activation. They are then taught to modulate their brain activity in a relaxed state through visual feedback. “Our research has shown the brain generates ongoing pain and we could change the rhythms, the frequency and the activity of the brain in a non-pharmaceutical way,” said Dr Gustin., 11 August 2017 ;