Sub-Grouping Healthy Subjects’ Sensitivity to Pain and Its Relationship to Personality Traits: Results of a Cluster Analysis


Objective: Individual differences in the sensitivity to pain and the factors that may contribute to these differences are well studied. Nevertheless, there is no single test that can reliably classify subjects as being sensitive or insensitive to pain. Methods: In the present study, hierarchical clustering and K-means cluster analysis was used to identify subgroups among 191 healthy subjects (105 females, 86 males) according to their sensitivity to pain. Group determination was based on the subjects’ response to experimental noxious stimuli of heat (pain intensity), cold (cold pain threshold, tolerance, and intensity), and conditioned pain modulation (CPM, tested by co-administering repeated short painful heat stimuli and a conditioning tonic cold pain stimulation). In addition, in order to determine if the subjects in these subgroups differed on personality traits scores on Cloninger’s Tridimensional Personality Questionnaire (TPQ, outcome measure) for the three dimensions of personality: Novelty Seeking (NS); Harm Avoidance (HA); and Reward Dependence (RD) were calculated. Results: Based on pain scores, subjects were grouped as low pain (57%) with a low level of sensitivity in pain parameters, or high pain (43%) cluster members. The high pain had significant higher scores of HA (p = 0.05) and RD (p = 0.05) than the low pain group. Conclusions: This method of sub-grouping may be useful for identifying the mechanisms underlying individual variability in the sensitivity to pain and may point to groups at risk for experiencing high levels of clinical pain.

Share and Cite:

Pud, D. , Treister, R. and Eisenberg, E. (2014) Sub-Grouping Healthy Subjects’ Sensitivity to Pain and Its Relationship to Personality Traits: Results of a Cluster Analysis. Applied Mathematics, 5, 1705-1712. doi: 10.4236/am.2014.511163.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Fillingim, R.B. (2005) Individual Differences in Pain Responses. Current Rheumatology Reports, 7, 342-347.
[2] Fillingim, R.B., King, C.D., Ribeiro-Dasilva, M.C., et al. (2009) Sex, Gender, and Pain: A Review of Recent Clinical and Experimental Findings. The Journal of Pain, 10, 447-485.
[3] Edwards, C.L., Fillingim, R.B. and Keefe, F. (2001) Race, Ethnicity and Pain. Pain, 94, 133-137.
[4] Gibson, S.J. and Helme, R.D. (2001) Age-Related Differences in Pain Perception and Report. Clinics in Geriatric Medicine, 17, 433.
[5] Sullivan, M.J., Thorn, B., Haythornthwaite, J.A., et al. (2001) Theoretical Perspectives on the Relation between Catastrophizing and Pain. Clinical Journal of Pain, 17, 52-64.
[6] Pud, D., Eisenberg, E., Sprecher, E., et al. (2004) The Tridimensional Personality Theory and Pain: Harm Avoidance and Reward Dependence Traits Correlate with Pain Perception in Healthy Volunteers. European Journal of Pain, 8, 31-38.
[7] Mogil, J.S., Wilson, S.G., Bon, K., et al. (1999) Heritability of Nociception II. Types’ of Nociception Revealed by Genetic Correlation Analysis. Pain, 80, 83-93.
[8] L?tsch, J. and Geisslinger, G. (2007) Current Evidence for a Modulation of Nociception by Human Genetic Polymorphisms. Pain, 132, 18-22.
[9] Nielsen, C.S., Stubhaug, A., Price, D.D., et al. (2008) Individual Differences in Pain Sensitivity: Genetic and Environmental Contributions. Pain, 136, 21-29.
[10] Nielsen, C.S., Staud, R. and Price, D.D. (2009) Individual Differences in Pain Sensitivity: Measurement, Causation, and Consequences. The Journal of Pain, 10, 231-237.
[11] Dodd, M.J., Miaskowski, C. and Paul, S.M. (2001) Symptom Clusters and Their Effect on the Functional Status of Patients with Cancer. Oncology Nursing Forum, 28, 465.
[12] Miaskowski, C., Cooper, B.A., Paul, S.M., et al. (2006) Subgroups of Patients with Cancer with Different Symptom Experiences and Quality-of-Life Outcomes: A Cluster Analysis. Oncology Nursing Society, 33, E79-E89.
[13] Barsevick, A.M. (2007) The Elusive Concept of the Symptom Cluster. Oncology Nursing Society, 34, 971-980.
[14] Pud, D., Ben Ami, S., Cooper, B.A., et al. (2008) The Symptom Experience of Oncology Outpatients Has a Different Impact on Quality-of-Life Outcomes. Journal of Pain and Symptom Management, 35, 162-170.
[15] Baron, R., T?lle, T.R., Gockel, U., et al. (2009) A Cross-Sectional Cohort Survey in 2100 Patients with Painful Diabetic Neuropathy and Postherpetic Neuralgia: Differences in Demographic Data and Sensory Symptoms. Pain, 146, 34-40.
[16] Scholz, J., Mannion, R.J., Hord, D.E., Griffin, R.S., Rawal, B., et al. (2009) A Novel Tool for the Assessment of Pain: Validation in Low Back Pain. PLoS Medicine, 6, Article ID: e1000047.
[17] Hastie, B.A., Riley III, J., Robinson, M.E., Glover, T., Campbell, C.M., et al. (2005) Cluster Analysis of Multiple Experimental Pain Modalities. Pain, 116, 227-237.
[18] Cloninger, C.R. (1986) A Unified Biosocial Theory of Personality and Its Role in the Development of Anxiety States. Psychiatric Developments, 4, 167-226.
[19] Cloninger, C.R. (1987) A Systematic Method for Clinical Description and Classification of Personality Variants: A Proposal. Archives of General Psychiatry, 44, 573-588.
[20] Cloninger, C.R., Thomas, R.P. and Dragan, M.S. (1991) The Tridimensional Personality Questionnaire: US Normative Data. Psychological Reports, 69, 1047-1057.
[21] Milligan, G.W. and Cooper M.C. (1985) An Examination of Procedures for Determining the Number of Clusters in a Data Set. Psychometrika, 50, 159-179.
[22] McQuitty, L.L. (1966) Similarity Analysis by Reciprocal Pairs for Discrete and Continuous Data. Educational and Psychological Measurement, 26, 825-831.
[23] Bruehl, S., Harden, R.N., Galer, B.S., Saltz, S., Backonja, M. and Stanton-Hicks, M. (2002) Complex Regional Pain Syndrome: Are There Distinct Subtypes and Sequential Stages of the Syndrome? Pain, 95, 119-124.
[24] Hurtig, I.M., Raak, R.I., Kendall, S.A., Bj?rn, G. and Karin, W.L. (2001) Quantitative Sensory Testing in Fibromyalgia Patients and in Healthy Subjects: Identification of Subgroups. Clinical Journal of Pain, 17, 316-322.
[25] Giesecke, T., Williams, D.A., Harris, R.E., Cupps, T.R., Tian, X., et al. (2003) Subgrouping of Fibromyalgia Patients on the Basis of Pressure-Pain Thresholds and Psychological Factors. Arthritis & Rheumatism, 48, 2916-2922.
[26] Harris, G. and Rollman, G.B. (1983) The Validity of Experimental Pain Measures. Pain, 17, 369-376.
[27] Cleeland, C.S., Nakamura, Y., Howland, E.W., Morgan, N.R., Edwards, K.R. and Backonja, M. (1996) Effects of Oral Morphine on Cold Pressor Tolerance Time and Neuropsychological Performance. Neuropsychopharmacology, 15, 252-262.
[28] Arendt-Nielsen, L. and Yarnitsky, D. (2009) Experimental and Clinical Applications of Quantitative Sensory Testing Applied to Skin, Muscles and Viscera. The Journal of Pain, 10, 556-572.
[29] Pud, D., Granovsky, Y., Yarnitsky, D. (2009) The Methodology of Experimentally Induced Diffuse Noxious Inhibitory Control (DNIC)-Like Effect in Humans. Pain, 144, 16-19.
[30] Treister, R., Eisenberg, E., Gershon, E., Haddad, M. and Pud, D. (2010) Factors Affecting–And Relationships between—Different Modes of Endogenous Pain Modulation in Healthy Volunteers. European Journal of Pain, 14, 608- 614.
[31] Phillips, J.M. and Gatchel, R.J. (2000) Extraversion—Introversion and Chronic Pain.
[32] Gatchel, R.J. and Weisberg, J.N. (2000) Personality Characteristics of Patients with Pain. American Psychological Association.
[33] Conrad, R., Schilling, G., Bausch, C., Nadstawek, J., Wartenberg, H.C., et al. (2007) Temperament and Character Personality Profiles and Personality Disorders in Chronic Pain Patients. Pain, 133, 197-209.
[34] Glazer, Y., Buskila, D., Cohen, H., Ebstein, R.P. and Neumann, L. (2010) Differences in the Personality Profile of Fibromyalgia Patients and Their Relatives with and without Fibromyalgia. Clinical and Experimental Rheumatology, 28, S27-S32.
[35] d’Agostino, V., Francia, E., Licursi, V. and Cerbo, R. (2010) Clinical and Personality Features of Allodynic Migraine. Neurological Sciences, 31, 159-161.
[36] Granot, M. (2005) Personality Traits Associated with Perception of Noxious Stimuli in Women with Vulvar Vestibulitis Syndrome. The Journal of Pain, 6, 168-173.
[37] Vlaeyen, J.W. and Linton, S.J. (2006) Are We “Fear-Avoidant”? Pain, 124, 240-241.
[38] Feldner, M.T. and Hekmat, H. (2001) Perceived Control over Anxiety-Related Events as a Predictor of Pain Behaviors in a Cold Pressor Task. Journal of Behavior Therapy and Experimental Psychiatry, 32, 191-202.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.