Painfully Sensitive: How Sensory Processing Sensitivity Affects Healthy Adolescents’ Perception of Pain

Jana Hochreuter,1– 3 Susanne Wehrli,1– 4 Cosima Locher,5,6 Francesca Lionetti,7 Joe Kossowsky,8,9 Michael Pluess,10,11 Helen Koechlin1– 3 1Department of Psychosomatics and Psychiatry, University Children’s Hospital, University of Zurich, Zurich, Switzerland; 2Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland; 3Children’s Research Centre, University Children’s Hospital Zurich, University of Zurich, Zurich, Switzerland; 4University Research Priority Program “ITINERARE –Innovative Therapies in Rare Diseases”, University of Zurich, Zurich, Switzerland; 5Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland; 6Faculty of Health, University of Plymouth, Plymouth, UK; 7Department of Neuroscience, Imaging and Clinical Sciences, G. d’Annunzio University of Chieti-Pescara, Chieti, Italy; 8Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA; 9Harvard Medical School, Boston, MA, USA; 10School of Psychology, University of Surrey, Guildford, UK; 11Department of Biological and Experimental Psychology, Queen Mary University, London, UKCorrespondence: Helen Koechlin, Email helen.koechlin@kispi.uzh.chObjective: Sensory processing sensitivity (SPS) describes a common trait characterized by lower sensory threshold, depth of processing, and ease of overstimulation. Low sensory threshold is also potentially important in the context of pain. To date, the relationship between SPS and pain perception has not been investigated, particularly in adolescents. This randomized experimental study aimed to explore whether SPS was associated with pain threshold and tolerance in healthy adolescents. Further, we examined differences in pain perception following positive, negative, or neutral mood induction.Methods: A total of 100 healthy adolescents aged 16 to 19 years were recruited through schools and online advertisement. Participants completed psychosocial questionnaires and underwent a randomized mood induction (positive, negative, or neutral). Pain levels (in °C) and self-reported pain tolerance and threshold were assessed by an experimental heat pain paradigm. Regression models were applied to determine effects of mood induction on pain perception, while multiple analyses of variance (ANOVAs) were computed to compare sensitivity across groups.Results: The mood induction significantly influenced self-reported pain ratings, demonstrating a positive interaction coefficient for the positive mood condition (b = 1.140, p < 0.01). ANOVAs revealed significant differences between sensitivity groups for baseline scores of pain threshold (F(2,97) = 5.009, p < 0.01) and tolerance (F(2,97) = 3.193, p < 0.05) (F(2,97) = 7.431, p < 0.001).Conclusion: Our findings reveal that highly sensitive adolescents had the lowest ratings of measured pain tolerance and threshold measures at baseline, suggesting heightened sensitivity to pain. This highlights the importance of considering sensory processing sensitivity in pain research, particularly in adolescent populations.Keywords: experimental pain, sensory processing sensitivity, adolescents