Effects of stimulus duration on heat induced pain: the relationship between real-time and post-stimulus pain ratings.

Pain is a temporally dynamic experience. Yet, in most instances, pain ratings are acquired in a static fashion and frequently require subjects to retrospectively evaluate the pain experience that occurred in a preceding interval of time. In order to determine which components of the real-time experience of pain contribute to static pain ratings, we obtained real-time (dynamic) and post-stimulus (static) ratings using a visual analogue scale during various of durations (5-30 s) of noxious thermal stimulation (43-49 degrees C). For both pain-intensity and pain-unpleasantness, real-time ratings revealed that pain adapted when stimulus temperatures were low to moderate and summated when stimulus temperature was high. Regression analyses examining both pain-intensity and pain-unpleasantness revealed that the mean response and the peak response of real-time ratings significantly contributed to post-stimulus ratings, while temporal components such as perceived duration of pain contributed minimally. Additional regression analyses revealed that mean and peak responses of real-time intensity ratings accounted for much of the variability of post-stimulus unpleasantness ratings whereas real-time unpleasantness ratings accounted for somewhat less of the variability of post-stimulus intensity ratings. Taken together, the close relationship between real-time and post-stimulus ratings of pain across stimulus conditions evoking both adaptation and temporal summation further confirms that post-stimulus, retrospective ratings of pain are valid measures of the real-time experience of pain.