The Effect of Social Support on the Development of Hyperalgesia: Do Attachment Styles Moderate the effect of Social Support on the Development of Hyperalgesia
Creators: name: Jaltare, Ketan
name: Torta, Diana
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Social and Behavioral Sciences
subject: HRV
subject: Hyperalgesia
subject: Pain
subject: Social Support
subject: Synchronisation

description: The social context within which pain occurs significantly impacts the experience of pain. Both active forms of social support like hand holding (Master et al., 2009) as well as passive/primed social support, through viewing photographs of one’s partner for instance, have been shown to reduce pain intensity and unpleasantness, as well as pain-related neural activity (Brown et al., 2003, Eisenberger et al., 2011). Moreover, social support has been shown to attenuate heart rate and cortisol reactivity to stress (Uchino et al., 1996) and to painful stimulations (Roberts et al., 2015), which can also be seen as a form of stress. In addition to attenuating the subjective experience of pain and the associated physiological reactivity, social touch (a form of social support) has also been shown to increase levels of touch-related physiological coupling between the individual experiencing pain and their social partner (eg, Goldstein et al., 2017 ; Goldstein et al., 2018). Given the significance of such physiological coupling in social contexts, it may well play an important role in the mechanisms through which the social context may impact the development of persistent pain. The relationship between social support and pain however is not straightforward. In studies on social support and acute pain, attachment styles (Bowlby, 1969) have been shown to moderate the effect of social support on pain. Specifically, anxiously attached individuals tend to report lower pain scores and exhibit decreased pain-related neural activity in the presence of support, whereas avoidantly attached individuals tend to exhibit the opposite effect (eg, Krahe et al., 2015 ; Krahe et al., 2016; Sambo et al., 2010). Research has also linked stressful life events to the extent of the area of hyperalgesia following the use of capsaicin (You et al., 2016), one of the human surrogate models of persistent pain. Interestingly, insecure attachment is also linked to dysregulation of the HPA axis, with insecurely attached individuals showing enhanced cortisol production as well as autonomic stress reactivity in response to stress compared to securely attached individuals (eg. Maunder et al., 2006, Smyth et al, 2015). Taken together, the above evidence suggests that aberrant stress reactivity may impact how insecurely attached individuals respond to a stressor like pain. There is an abundance of correlational data on insecure attachment and chronic pain among patient populations : insecure attachment has been linked to maladaptive coping styles, pain catastrophising, more depressive symptoms, lower pain self-efficacy and greater pain-related disability (Rossi et al., 2005 ; Meredith et al., 2008). Studies have also linked insecure attachment to increased psychological distress, threatening pain appraisal and pain-related fear (Pearce et al, 2001; McWilliams &amp; Asmundson, 2007). However, given the correlational nature of these findings, these existing data from clinical populations preclude any inferences about the exact underlying mechanisms that may lead to chronic pain. The present study will use a human surrogate model of neuropathic pain to investigate the following questions: Does social support attenuate the development of hyperalgesia in healthy participants? Do attachment styles moderate the effect of social support on the development of hyperalgesia? Does social support lead to lower levels of persistent pain in participants with higher attachment anxiety, as compared to participants with higher attachment avoidance?