Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy
Although sedatives can defuse anxiety and relieve pain, Esophagogastroduodenoscopy (EGD) still is uncomfortable and threatening for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. Using a prospective design and a multimodal assessment of pain, the pr...
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doaj-4b59ff0cbe41491d91a10d0556623a8b2020-11-25T01:14:54ZengFrontiers Media S.A.Frontiers in Psychology1664-10782019-05-011010.3389/fpsyg.2019.01112455355Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper EndoscopyMarco Lauriola0Manuela Tomai1Rossella Palma2Gaia La Spina3Anastasia Foglia4Cristina Panetta5Marilena Raniolo6Stefano Pontone7Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, ItalyDepartment of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, ItalyDepartment of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, ItalyDepartment of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, ItalyDepartment of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, ItalyDepartment of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, ItalyDepartment of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, ItalyDepartment of Surgical Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, ItalyAlthough sedatives can defuse anxiety and relieve pain, Esophagogastroduodenoscopy (EGD) still is uncomfortable and threatening for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. Using a prospective design and a multimodal assessment of pain, the present study evaluated how anxiety-related variables predicted subsequent pain outcomes. Sixty-two consecutive patients referred for elective EGD were assessed for intolerance of uncertainty (IU), procedure-related worries, anxiety sensitivity and health distress before endoscopy. During endoscopy, a doctor rated patients’ pain behavior. After complete recovery from sedation, the patients retrospectively rated endoscopy pain and situation specific catastrophizing thoughts. Descriptive analyses showed that patients undergoing EGD for the first time were more distressed and anxious than patients accustomed to the procedure and needed a higher sedative dose. Notwithstanding sedation, the behavioral rating of pain was above the cut-off value for probable pain for more than half of the patients. IU assessed before endoscopy predicted situational pain catastrophizing (PC) and self-reported pain after endoscopy through procedure related worries. Situational PC not only mediated the effect of worry, but also female gender and younger age were associated with self-reported pain through increased catastrophizing thoughts. Health distress and anxiety sensitivity predicted PC only for women, younger patients, and those not accustomed to the procedure. Our study showed that psychological preparation before sedation is needed especially for first-timers, women, and younger patients, addressing maladaptive cognitive beliefs and acquainting patients with the somatic sensations that they might experience during the procedure.https://www.frontiersin.org/article/10.3389/fpsyg.2019.01112/fullintolerance of uncertaintyanxiety-sensitivityprocedural anxietypain catastrophizingesophagogastroduodenoscopyprospective-study |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marco Lauriola Manuela Tomai Rossella Palma Gaia La Spina Anastasia Foglia Cristina Panetta Marilena Raniolo Stefano Pontone |
spellingShingle |
Marco Lauriola Manuela Tomai Rossella Palma Gaia La Spina Anastasia Foglia Cristina Panetta Marilena Raniolo Stefano Pontone Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy Frontiers in Psychology intolerance of uncertainty anxiety-sensitivity procedural anxiety pain catastrophizing esophagogastroduodenoscopy prospective-study |
author_facet |
Marco Lauriola Manuela Tomai Rossella Palma Gaia La Spina Anastasia Foglia Cristina Panetta Marilena Raniolo Stefano Pontone |
author_sort |
Marco Lauriola |
title |
Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy |
title_short |
Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy |
title_full |
Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy |
title_fullStr |
Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy |
title_full_unstemmed |
Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy |
title_sort |
intolerance of uncertainty and anxiety-related dispositions predict pain during upper endoscopy |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Psychology |
issn |
1664-1078 |
publishDate |
2019-05-01 |
description |
Although sedatives can defuse anxiety and relieve pain, Esophagogastroduodenoscopy (EGD) still is uncomfortable and threatening for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. Using a prospective design and a multimodal assessment of pain, the present study evaluated how anxiety-related variables predicted subsequent pain outcomes. Sixty-two consecutive patients referred for elective EGD were assessed for intolerance of uncertainty (IU), procedure-related worries, anxiety sensitivity and health distress before endoscopy. During endoscopy, a doctor rated patients’ pain behavior. After complete recovery from sedation, the patients retrospectively rated endoscopy pain and situation specific catastrophizing thoughts. Descriptive analyses showed that patients undergoing EGD for the first time were more distressed and anxious than patients accustomed to the procedure and needed a higher sedative dose. Notwithstanding sedation, the behavioral rating of pain was above the cut-off value for probable pain for more than half of the patients. IU assessed before endoscopy predicted situational pain catastrophizing (PC) and self-reported pain after endoscopy through procedure related worries. Situational PC not only mediated the effect of worry, but also female gender and younger age were associated with self-reported pain through increased catastrophizing thoughts. Health distress and anxiety sensitivity predicted PC only for women, younger patients, and those not accustomed to the procedure. Our study showed that psychological preparation before sedation is needed especially for first-timers, women, and younger patients, addressing maladaptive cognitive beliefs and acquainting patients with the somatic sensations that they might experience during the procedure. |
topic |
intolerance of uncertainty anxiety-sensitivity procedural anxiety pain catastrophizing esophagogastroduodenoscopy prospective-study |
url |
https://www.frontiersin.org/article/10.3389/fpsyg.2019.01112/full |
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