Relationship between Personality Traits and Endogenous Analgesia: The Role of Harm Avoidance

Hadas Nahman-Averbuch, David Yarnitsky, Elliot Sprecher, Yelena Granovsky, Michal Granot

Research output: Contribution to journalArticlepeer-review


Background: Whether psychological factors such as anxiety and pain catastrophizing levels influence the expression of endogenous analgesia in general and, more specifically, the conditioned pain modulation (CPM) response is still under debate. It may be assumed that other psychological characteristics also play a role in the CPM response. The neurotransmitters serotonin, dopamine, and norepinephrine are involved both in CPM, as well as personality traits such as harm avoidance (HA), novelty seeking (NS), and reward dependence (RD), which can be obtained by the Tridimensional Personality Questionnaire (TPQ). However, the associations between these traits (HA, NS, and RD) with endogenous analgesia revealed by CPM have not yet been explored. Methods: Healthy middle-age subjects (n = 28) completed the TPQ, Spielberger's State Anxiety Inventory, and the Pain Catastrophizing Scale and were assessed for CPM paradigms using thermal phasic temporal summation as the "test stimulus" and hand immersion into hot water bath (CPM water) or contact heat (CPM contact) for "conditioning stimulus." Results: Higher levels of HA were associated with less-efficient CPM responses obtained by both paradigms: CPM water (r = 0.418, P = 0.027) and CPM contact (r = 0.374, P = 0.050). However, NS and RD were not associated with the other measurements. No significant relationship was observed between state anxiety and pain catastrophizing levels and the CPM responses. Conclusions: The relationship between the capacity of endogenous analgesia and the tendency to avoid aversive experience can be explained by mutual mechanisms involving similar neurotransmitters or brain areas. These findings illuminate the key role of harm avoidance obtained by the TPQ in determining the characteristics of pain modulation profile.

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalPain Practice
Issue number1
StatePublished - 1 Jan 2016

Bibliographical note

Publisher Copyright:
© 2016 World Institute of Pain.


  • Anxiety
  • Conditioned pain modulation
  • Harm avoidance
  • Pain catastrophizing
  • Tridimensional Personality Questionnaire

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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