The relationship between body image and response to experimental pain
Nichols, David Crosman
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This study grew out of the general problem area concerning the relationship between psychological factors and response to pain. The specific variable focused upon was body image, broadly defined as a constellation of body attitudes and ways of experiencing the body, two of which -- body anxiety and body boundary definiteness -- were studied intensively. Body anxiety, defined as the degree of concern, conflict or anxiety a person experiences about his body, was measured by the Homonym Test, developed by Secord. This is a word association test involving 75 words which can have either a body or a non-body meaning such as "graft" or "colon". Two general measures of anxiety, theTaylor Manifest Anxiety Scale and Holtzman's adaptation of the Elizur Content Anxiety Scale, were also administered. The second body image variable, body boundary definiteness, was defined as an index of a person's sense of differentiation from the world as a separate, intact entity. It was further considered to be an index of the development of differentiated ego boundaries, reflecting highly developed ego-functioning, and consequently, the capacity to modulate response to stress. In order to measure body boundary definiteness, the barrier score of Fisher and Cleveland was used. This score is based on an analysis of inkblot responses emphasizing protective, containing or concealing features. Three aspects of response to pain were studied; these were pain perception, pain tolerance, and adaptation to pain. Operationally, pain perception was measured in terms of the intensity at which an electric shock to the forearm was judged as "uncomfortable" and the level at which it was judged as "painful ". Pain tolerance was likewise measured in two ways. The first, "unmotivated tolerance level", was the point at which subjects first refused to receive higher intensities of shock. The second, "motivated tolerance level", was the point at which subjects refused to go higher following mild urging to go as high as they possibly could. Finally, adaptation to pain was measured in terms of the amount of increase in each of the pain perception and tolerance levels as a result of repeating the level setting procedure following a period of repeated shocks. The specific hypotheses tested in the study were: 1) Definiteness of body boundaries is positively correlated with pain perception threshold. 2) Body anxiety is negatively correlated with pain perception threshold. 3) Definiteness of body boundaries is positively correlated with ability to tolerate pain. 4) Body anxiety is negatively correlated with ability to tolerate pain. 5) Definiteness of body boundaries is positively correlated with adaptation to pain. 6) Body anxiety is negatively correlated with adaptation to pain. The results, based on a sample of 30 subjects, supported only hypotheses one and three, those involving body boundary definiteness. There were significant correlations between the Barrier scores and painful level, unmotivated tolerance level, and motivated tolerance level. The hypothesized relationship between body anxiety and pain perception and pain tolerance were not supported by the experimental results. Neither of the body image variables was correlated with adaptation to pain as stated in hypotheses five and six. This was seen to be the result of the fact that most of the subjects were highly stable in their judgements about pain and in their ability to tolerate pain. Thus, adaptation did not occur. In addition, it was found that the Holtzman Content Anxiety scores were negatively correlated with the two pain tolerance measures. There was a tendency toward an inverted-U shaped relationship between tvlanifest Anxiety and pain perception level and motivated tolerance level. The results of the study were considered to provide partial support for the assumption that body image variables are relevant to response to pain.
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