Papers of the Week

Handholding reduces experimentally induced acute pain, and buffers against the development of mechanical secondary hypersensitivity, an indirect proxy of central sensitization. Here, we tested if verbal support from a stranger, a common occurrence in clinical contexts, exerts the same effects. In this pre-registered study, forty-four healthy female participants were assigned to an alone or support group whereby a supportive female stranger encouraged them through the painful procedure leading to secondary mechanical hypersensitivity. Mechanical hypersensitivity was measured via self-reports and by the size of the anteroposterior and mediolateral spread of mechanical hypersensitivity. We investigated the moderating role of attachment style on self-reports, and the effects of support on skin conductance level, salivary cortisol, and pinprick evoked potentials. We also tested whether theta/beta ratio in the resting-state EEG predicted mechanical hypersensitivity. Self-reported ratings and the late part of the pinprick evoked potentials were reduced in the support group, but the spread of mechanical hypersensitivity was not. Attachment anxiety and avoidance moderated the self-reported intensity such that individuals with higher attachment anxiety and avoidance scores reported lower intensity ratings in the support group. No significant effect of the verbal support was observed on skin conductance level and salivary cortisol. The theta/beta ratio did not predict the extent of hypersensitivity. Our data indicate that in women, verbal support during intense pain leading to hypersensitivity is effective on some behavioural outcomes, but altogether the lack of group differences in cortisol, self-reported stress and skin conductance do not provide strong support for the stress-buffering hypothesis. PERSPECTIVE: Verbal support by a stranger during a painful procedure leading to secondary mechanical hypersensitivity attenuated the development of some measures of mechanical hypersensitivity and associated neural responses in healthy female participants. No evidence was found for a role of stress. DATA AVAILABILITY: The authors will make all data available upon request.