The relationship between dissociation and acute pain: the impact of prior and reactive dissociation

Acute pain can trigger reactions related to acute stress. Such reactions may also include peritraumatic dissociative symptoms. The aim of this experimental study was threefold: (a) to examine which type of dissociation symptoms (DiSym) are associated with acute pain, (b) to assess how DiSym affect pain tolerance, intensity and psychophysiological response and, (c) to evaluate the effect of prior DiSym on the development of further symptoms of dissociation and on pain. A dissociation group (DG) underwent dissociation induction through audio photic stimulation prior to exposure to a painful stimulus (cold water immersion) whereas a control group (CG) underwent exposure only to the painful stimulus. All participants were undergraduate psychology students invited through announcements (47 women, 6 men. Mean age = 21, SD = 1.4). State and peritraumatic dissociation symptoms were assessed; pain was assessed through a visual analogue scale, and tolerance through total immersion time. We found that acute pain was related to somatoform DiSym in both groups (p < .001, η2 = .39). Participants in the DG reported more psychological and state DiSym and exhibited lower pain tolerance (p = .001, d = .82) than CG participants, as well as significant heart rate increase during cold water immersion (p < .001, d = .77). We conclude that certain forms of DiSym may emerge spontaneously in response to acute pain. A detrimental effect on pain intensity/ tolerance was associated to prior symptoms of dissociation. Moreover, DiSym induced prior to exposure to pain may contribute to the development of further dissociation symptoms. Thus, dissociation screening in all pain conditions may improve clinical interventions’ efficacy.