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62. Dimensional analysis of psychological symptoms in multimodal experimental pain sensitivity in women with pelvic pain
Despite the prevalence of period pain (>50% of reproductive age women), the role of psychological factors and pain sensitivity is unknown. Prior work has suggested that women with dysmenorrhea have more experimental pain sensitivity on quantitative sensory testing (QST) measures when compared to healthy controls, but confounding effects of anxiety and depression have not yet been clarified. Therefore, we conducted QST and evaluated psychological symptoms to evaluate their relationship in healthy controls (HC, n = 37), women with dysmenorrhea (DYS, n = 196), and women with bladder pain syndrome (BPS, n = 25). Psychological symptoms were assessed with the Brief Symptom Inventory subscale for somatic symptoms, the Pain Catastrophizing Scale, and the PROMIS scales (anxiety, depression, pain behavior, and pain interference). As predicted, we confirmed that DYS and BPS participants had increased experimental pain sensitivity (measured with QST) and more severe anxiety, depression, and pain catastrophizing symptoms relative to healthy controls. To evaluate whether increased pain sensitivity, as measured with QST, or increased levels of pain report were related to psychological symptoms, we conducted correlational analyses that showed that increased experimental bladder sensitivity was related to self-reported menstrual pain (r = 0.26), bladder pain (r = 0.57), pain during sexual intercourse (r = 0.39), and bowel pain (r = 0.45). However, there were no significant associations among anxiety, depression, and experimental pain sensitivity results. These results suggest that a mechanism involving increased sensitivity, independent of anxiety and depression, is associated with increased pelvic pain report.