{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:35:52Z","timestamp":1789580152451,"version":"build-2803163510"},"reference-count":58,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,4,7]],"date-time":"2015-04-07T00:00:00Z","timestamp":1428364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001866","name":"Fonds National de la Recherche Luxembourg","doi-asserted-by":"publisher","award":["PASCOM"],"award-info":[{"award-number":["PASCOM"]}],"id":[{"id":"10.13039\/501100001866","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pain has consistently been viewed as containing two dimensions, a sensory (intensity) and an emotional (unpleasantness). It has been suggested that pain involves higher order cognitive processes that go beyond unpleasantness. We therefore aimed at extending the assessment of pain by introducing an additional dimension of pain\u2010related suffering and identifying noxious stimulation protocols that are most adequate for its psychophysical and psychophysiological characterization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010four healthy volunteers received separate series of tonic and phasic noxious mechanical stimuli. Visual analogue scales were used to rate intensity, unpleasantness and suffering and psychophysiological measurements such as heart rate, skin conductance and corrugator electromyography were recorded. Acoustically evoked startle responses were measured in part of the assessments to obtain additional indicators of pain aversiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Spearman's correlation coefficients and partial correlations analyses as well as principal component analyses confirmed that suffering constitutes an integral component of pain processing that is distinct from intensity and unpleasantness. Tonic, rather than phasic, stimulation method was more effective in eliciting pain and suffering and under this condition startle responses where higher during long compared to short stimuli.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results suggest that in acute pain, suffering is a constitutive dimension that might even be more crucial in clinical states of pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.709","type":"journal-article","created":{"date-parts":[[2015,4,7]],"date-time":"2015-04-07T02:27:05Z","timestamp":1428373625000},"page":"1035-1048","source":"Crossref","is-referenced-by-count":26,"title":["Suffering as an independent component of the experience of\u00a0pain"],"prefix":"10.1002","volume":"19","author":[{"given":"S.","family":"Bustan","sequence":"first","affiliation":[{"name":"Institute for Health and Behavior FLSHASE\/INSIDE University of Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Gonzalez\u2010Roldan","sequence":"additional","affiliation":[{"name":"Institute for Health and Behavior FLSHASE\/INSIDE University of Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Kamping","sequence":"additional","affiliation":[{"name":"Center for Translational Research in Systems Neuroscience and Psychiatry Department of Psychiatry and Psychotherapy University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Brunner","sequence":"additional","affiliation":[{"name":"Department of Cognitive and Clinical Neuroscience Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"L\u00f6ffler","sequence":"additional","affiliation":[{"name":"Department of Cognitive and Clinical Neuroscience Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Flor","sequence":"additional","affiliation":[{"name":"Department of Cognitive and Clinical Neuroscience Central Institute of Mental Health, Medical Faculty Mannheim University of Heidelberg Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Anton","sequence":"additional","affiliation":[{"name":"Institute for Health and Behavior FLSHASE\/INSIDE University of Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,4,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1983.49.1.111"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0771(199803)11:1<19::AID-BDM277>3.0.CO;2-B"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199904)22:4<443::AID-MUS3>3.0.CO;2-N"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02292765"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-006-0587-x"},{"key":"e_1_2_8_7_1","volume-title":"Wahrnehmung der Muskelspannung: signalentdeckungstheoretische Untersuchungen bei Personen mit Muskelkontraktionskopfschmerz","author":"Bischoff C.","year":"1989"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20108986.2005.00271.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(89)90128-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7916(94)90063-9"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/08869634.1989.11678277"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198203183061104"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)90040-3"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/0096-1523.12.1.103"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(89)90149-8"},{"key":"e_1_2_8_16_1","first-page":"285","volume-title":"Issues in Pain Measurement","author":"Clark W.C.","year":"1989"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00474-2"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2003.08.005"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0310.2010.01846.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00139-6"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1082-3174(11)80022-X"},{"key":"e_1_2_8_22_1","volume-title":"Structured Clinical Interview for DSM\u2010IV Axis I Disorders, Research Version, Non\u2010Patient Edition (SCID\u2010I\/NP)","author":"First M.B.","year":"2002"},{"key":"e_1_2_8_23_1","volume-title":"Psychobiolgie des Schmerzes","author":"Flor H.","year":"1991"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(93)90044-U"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1037\/0003-066X.43.4.276","article-title":"Pain and suffering: A reappraisal","volume":"43","author":"Fordyce W.E.","year":"1988","journal-title":"Am Psychol"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01990960"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.65.1.45"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-2457(03)00202-5"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.11.014"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03212212"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/08990229309028821"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02291575"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.44.3.406"},{"key":"e_1_2_8_34_1","volume-title":"University of Trier: Clip\u2010Software for the Analysis of Physiological Data","author":"Kinzig C.","year":"2008"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.11.003"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(91)90037-X"},{"key":"e_1_2_8_37_1","first-page":"139","article-title":"Investigations with a German version of the \u201cPositive and Negative Affect Schedule\u201d (PANAS)","volume":"42","author":"Krohne H.W.","year":"1996","journal-title":"Diagnostica"},{"key":"e_1_2_8_38_1","first-page":"Doc01","article-title":"The effects of sex and gender role on responses to pressure pain","volume":"9","author":"Kr\u00f6ner\u2010Herwig B.","year":"2012","journal-title":"Psychosoc Med"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.97.3.377"},{"key":"e_1_2_8_40_1","volume-title":"Das State\u2010Trait\u2010Angstinventar, Theoretische Grundlagen und Handanweisung","author":"Laux L.","year":"1981"},{"key":"e_1_2_8_41_1","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/978-1-349-05952-2_34","volume-title":"Proceedings of the First World Conference on Clinical Pharmacology and Therapeutics","author":"Loeser J.D.","year":"1980"},{"key":"e_1_2_8_42_1","volume-title":"A Manual of Psychophysiological Methods","author":"Martin I.","year":"1967"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018782831217"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(75)90044-5"},{"key":"e_1_2_8_45_1","first-page":"423","volume-title":"The Skin Senses","author":"Melzack R.","year":"1968"},{"key":"e_1_2_8_46_1","volume-title":"Classification of Chronic Pain","author":"Merskey H.","year":"1994"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0082(98)00048-3"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.41.2.397"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-3932(71)90067-4"},{"key":"e_1_2_8_50_1","volume-title":"Psychological and Neural Mechanisms of Pain","author":"Price D.","year":"1988"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.288.5472.1769"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1124\/mi.2.6.392"},{"key":"e_1_2_8_53_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.7551\/mitpress\/8145.001.0001","volume-title":"Inner Experience and Neuroscience \u2013 Merging Both Perspectives","author":"Price D.","year":"2012"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8986.1975.tb00069.x"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.3109\/08990229209144776"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdm.3960050303"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(96)03162-4"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4637.2002.02008.x"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.54.6.1063"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fejp.709","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T09:36:18Z","timestamp":1695548178000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,7]]},"references-count":58,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1002\/ejp.709"],"URL":"https:\/\/doi.org\/10.1002\/ejp.709","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,7]]}}}