The purpose of this narrative review is to discuss the interrelations between pain, stress and executive functions.
Implications for practice:
Self-regulation, through executive functioning, exerts control over cognition, emotion and behaviour. The reciprocal neural functional connectivity between the prefrontal cortex and the limbic system allows for the integration of cognitive and emotional neural pathways and then for higher-order psychological processes (reasoning, judgement etc.) to generate goal-directed adaptive behaviours and to regulate responses to psychosocial stressors and pain signals. Impairment in cognitive executive functioning may result in poor regulation of stress-, pain- and emotion-related processing of information. Conversely, adverse emotion, pain and stress impair executive functioning. The characteristic of the feedback and feedforward neural connections (quantity and quality) between the prefrontal cortex and the limbic system determine adaptive behaviour, stress response and pain experience.
FellerLKhammissaRAGBallyramR, et al. Chronic psychosocial stress in relation to cancer. Middle East J Cancer2019; 10(1): 1–8.
2.
ColomboBRoccaMAMessinaR, et al. Resting-state fMRI functional connectivity: a new perspective to evaluate pain modulation in migraine. Neurol Sci2015; 36(Suppl. 1): 41–45.
3.
CharmandariETsigosCChrousosG.Endocrinology of the stress response. Annu Rev Physiol2005; 67: 259–284.
4.
CohenSJanicki-DevertsDDoyleWJ, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci U S A2012; 109(16): 5995–5999.
5.
MuscatellKAEisenbergerNI.A social neuroscience perspective on stress and health. Soc Personal Psychol Compass2012; 6(12): 890–904.
6.
BoyceJAAustenKF.Allergies, anaphylaxis, and systemic mastocytosis. In: KasperDLFauciASHauserSL, et al. (eds) Harrison’s principles of internal medicine, vol. 2. New York: McGraw-Hill, 2015, pp. 2113–2124.
7.
ChikanzaICGrossmanAB.Neuroendocrine immune responses to inflammation: the concept of the neuroendocrine immune loop. Baillieres Clin Rheumatol1996; 10: 199–225.
8.
VeerIMOeiNYSpinhovenP, et al. Endogenous cortisol is associated with functional connectivity between the amygdala and medial prefrontal cortex. Psychoneuroendocrinology2012; 37(7): 1039–1047.
9.
RaioCMOrederuTAPalazzoloL, et al. Cognitive emotion regulation fails the stress test. Proc Natl Acad Sci U S A2013; 110(37): 15139–15144.
10.
WilliamsPGThayerJF.Executive functioning and health: introduction to the special series. Ann Behav Med2009; 37(2): 101–105.
11.
WilliamsPGSuchyYRauHK.Individual differences in executive functioning: implications for stress regulation. Ann Behav Med2009; 37(2): 126–140.
12.
SchmeichelBJ.Attention control, memory updating, and emotion regulation temporarily reduce the capacity for executive control. J Exp Psychol Gen2007; 136(2): 241–255.
13.
ShieldsGSKuchenbeckerSYPressmanSD, et al. Better cognitive control of emotional information is associated with reduced pro-inflammatory cytokine reactivity to emotional stress. Stress2016; 19(1): 63–68.
14.
QuinnMEJoormannJ.Control when it counts: change in executive control under stress predicts depression symptoms. Emotion2015; 15(4): 522–530.
15.
QuinnMEJoormannJ.Stress-induced changes in executive control are associated with depression symptoms: examining the role of rumination. Clin Psychol Sci2015; 3(4): 628–636.
16.
GodsilBPKissJPSpeddingM, et al. The hippocampal-prefrontal pathway: the weak link in psychiatric disorders. Eur Neuropsychopharmacol2013; 23(10): 1165–1181.
17.
Cardoso-CruzHLimaDGalhardoV.Impaired spatial memory performance in a rat model of neuropathic pain is associated with reduced hippocampus-prefrontal cortex connectivity. J Neurosci2013; 33(6): 2465–2480.
18.
RayRDZaldDH.Anatomical insights into the interaction of emotion and cognition in the prefrontal cortex. Neurosci Biobehav Rev2012; 36(1): 479–501.
19.
McKlveenJMMyersBHermanJP.The medial prefrontal cortex: coordinator of autonomic, neuroendocrine and behavioural responses to stress. J Neuroendocrinol2015; 27(6): 446–456.
20.
InzlichtMGutsellJN.Running on empty: neural signals for self-control failure. Psychol Sci2007; 18(11): 933–937.
21.
JohnsonACGreenwood-Van MeerveldB.Stress-induced pain: a target for the development of novel therapeutics. J Pharmacol Exp Ther2014; 351(2): 327–335.
22.
LaraucheMMulakATacheY.Stress and visceral pain: from animal models to clinical therapies. Exp Neurol2012; 233(1): 49–67.
23.
LiXHuL.The role of stress regulation on neural plasticity in pain chronification. Neural Plast2016; 2016: 6402942.
24.
MalekiNBecerraLBrawnJ, et al. Common hippocampal structural and functional changes in migraine. Brain Struct Funct2013; 218(4): 903–912.
25.
Vachon-PresseauERoyMMartelMO, et al. The stress model of chronic pain: evidence from basal cortisol and hippocampal structure and function in humans. Brain2013; 136(Pt. 3): 815–827.
26.
HashmiJABalikiMNHuangL, et al. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain2013; 136(Pt. 9): 2751–2768.
27.
NijsJTorres-CuecoRvan WilgenCP, et al. Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain. Pain Physician2014; 17(5): 447–457.
28.
ChrousosGP.Stress and disorders of the stress system. Nat Rev Endocrinol2009; 5(7): 374–381.
29.
ShieldsGSSazmaMAYonelinasAP.The effects of acute stress on core executive functions: a meta-analysis and comparison with cortisol. Neurosci Biobehav Rev2016; 68: 651–668.
30.
SlavichGMColeSW.The emerging field of human social genomics. Clin Psychol Sci2013; 1(3): 331–348.
31.
SlavichGMIrwinMR.From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychol Bull2014; 140(3): 774–815.
32.
DaveNDXiangLRehmKE, et al. Stress and allergic diseases. Immunol Allergy Clin2011; 31(1): 55–68.
33.
MontoroJMullolJJaureguiI, et al. Stress and allergy. J Invest Allerg Clin2009; 19(Suppl. 1): 40–47.
34.
KarpinskiRIKinase KolbAMTetreaultNA, et al. High intelligence: a risk factor for psychological and physiological overexcitabilities. Intelligence2017; 66: 8–23.
35.
FellerLFourieJBouckaertM, et al. Burning mouth syndrome: aetiopathogenesis and principles of management. Pain Res Manag2017; 2017: 1926269.
36.
FellerLKhammissaRAGBouckaertM, et al. Pain: persistent postsurgery and bone cancer-related pain. J Int Med Res2019; 47(2): 528–543.
37.
ScheierMFWeintraubJKCarverCS.Coping with stress: divergent strategies of optimists and pessimists. J Pers Soc Psychol1986; 51(6): 1257–1264.
38.
ComptonRJHofheimerJKazinkaR.Stress regulation and cognitive control: evidence relating cortisol reactivity and neural responses to errors. Cogn Affect Behav Neurosci2013; 13(1): 152–163.
CillessenLJohannsenMSpeckensAEM, et al. Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: a systematic review and meta-analysis of randomized controlled trials. Psychooncology. Epub ahead of print 29 August 2019. DOI: 10.1002/pon.5214.
41.
DensonTFSpanovicMMillerN.Cognitive appraisals and emotions predict cortisol and immune responses: a meta-analysis of acute laboratory social stressors and emotion inductions. Psychol Bull2009; 135(6): 823–853.
42.
ComptonRJArnsteinDFreedmanG, et al. Neural and behavioral measures of error-related cognitive control predict daily coping with stress. Emotion2011; 11(2): 379–390.
43.
DickersonSSKemenyME.Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull2004; 130(3): 355–391.
44.
Negron-OyarzoIAboitizFFuentealbaP.Impaired functional connectivity in the prefrontal cortex: a mechanism for chronic stress-induced neuropsychiatric disorders. Neural Plast2016; 2016: 7539065.
45.
JohnsonNJohnsonSFYaoW, et al. Stabilization of mutant BRCA1 protein confers PARP inhibitor and platinum resistance. Proc Natl Acad Sci U S A2013; 110: 17041–17046.
46.
GrossiGPerskiAOsikaW, et al. Stress-related exhaustion disorder–clinical manifestation of burnout? A review of assessment methods, sleep impairments, cognitive disturbances, and neuro-biological and physiological changes in clinical burnout. Scand J Psychol2015; 56(6): 626–636.
47.
OchsnerKNGrossJJ.The cognitive control of emotion. Trends Cogn Sci2005; 9(5): 242–249.
48.
CraigSLMcInroyLBEatonAD, et al. An affirmative coping skills intervention to improve the mental and sexual health of sexual and gender minority youth (project youth AFFIRM): protocol for an implementation study. JMIR Res Protoc2019; 8(6): e13462.
49.
PatelRSSekhriSBhimanadhamNN, et al. A review on strategies to manage physician burnout. Cureus2019; 11(6): e4805.
50.
KuhlmanKRChiangJJBowerJE, et al. Persistent low positive affect and sleep disturbance across adolescence moderate link between stress and depressive symptoms in early adulthood. J Abnorm Child Psychol. Epub ahead of print 24 August 2019. DOI: 10.1007/s10802-019-00581-y.
51.
GarlandELFarbNAGoldinP, et al. Mindfulness broadens awareness and builds eudaimonic meaning: a process model of mindful positive emotion regulation. Psychol Inq2015; 26(4): 293–314.
