New research published in Behavior Research and Therapy finds that individuals with depression who experience stigmatization are also likely to feel pain more intensely and also cognitively catastrophize pain. This research can help clinicians understand and treat those individuals facing stigmatization while coping with depression’s physical symptoms.
Depression is a type of mental illness associated with internal symptoms and social stigmatization. People with mental illnesses are often subject to negative attitudes and stereotypes, leading to decreased self-esteem, reduced self-efficacy, and psychological distress.
Depression patients may also experience unexplained physical pain, which can worsen due to both depressive and painful symptoms. But the connection between stigmatization and pain perception is not yet fully understood; Ming Zhang and colleagues sought to discover more about this connection.
The research team hypothesized that people with mental illness who experience stigma would have a greater perception of pain, leading to higher self-reported pain assessments and pain perception. To test this hypothesis, two studies were conducted. In study 1, 95 participants were recruited; 27 were placed in the “stigma” condition, and the remaining in the control group.
Those in the experimental condition were asked to reflect upon times when they felt they were stigmatized because of their mental health. Immediately after the reflection, both groups took assessments relating to pain, including the Pain Sensitivity Questionnaire, Pain Vigilance and Awareness Questionnaire, and Pain Catastrophizing Scale.
Study 2 included 43 participants (all from study 1), 15 of whom were in the stigma group. In this study, participants established their pain tolerance, and then they were given various pulses of heat on their arm, and they were asked to rate the pain of these pulses on a 1 to 10 scale.
The study’s findings indicated that depression stigma is associated with increased pain catastrophizing. Pain catastrophizing is a term used to describe a type of negative thinking pattern that some people experience when they are in pain. It refers to the tendency to amplify and exaggerate the experience of pain. The researchers also found that stigmatization was associated with an increased pain threshold.
The research team acknowledged a few limitations to their study—first, the sample sizes, in particular, the size of the “stigma” groups, were relatively small. Second, the study was conducted with a group seeking treatment in a clinical setting. As stigmatization often causes people to not seek treatment, the results may not reflect the experiences of those who do not seek treatment.
Zhang and colleagues conclude, “stigmatized experience affected depressed patients’ pain catastrophizing and evoked pain perception. These findings provide new experimental evidence that stigmatization affects the physical perception of depressed patients. Furthermore, they suggest that a focus on minimizing stigmatization may help patients maintain healthier physical and psychological states and improve clinical interventions for depression.”
The study “Stigmatized experience is associated with exacerbated pain perception in depressed patients“, was authored by Ming Zhang, Yuqi Zhang, Yue Zhu, Xiaomin Lin, Yongkang Zhi, Yupu Zhu, Chuan Shi, and Yazhuo Kong.