Anticipatory stress reduction among chronic pain patients.

Stress has long been viewed as a contributor to the pain experienced by chronic pain patients. The purpose of this research was to study the relationship between anticipated and experienced stress and anticipated and experienced pain levels among three patient groups: chronic pain patients, patients about to receive molar extraction (acute pain group), and a no-pain comparison group. Results showed that chronic pain patients anticipated significantly more stress than did an acute pain or a non-pain comparison patient group but reported non-significant differences in the actual level of stress experienced. A secondary purpose of this study was to examine cognitive factors, such as perceived daily hassles, which may contribute to this increased anticipatory stress. Results showed that there was consistency among the chronic pain patients as to the types of anticipated stressors, which were similar to those previously reported by chronic headache sufferers. The chronic pain group had significantly higher scores than the two remaining groups on the stress they anticipated from hassles related both to practical considerations (F2.45 = 3.5, p < 0.05) and to health (F2.45 = 9.37, p < 0.001). Strategies the dentist can use in combination with dental therapy to reduce cognitive-based anticipatory stress as well as strategies for collaboration with the patient and a mental health therapist are discussed.