The Relationship between Multisensory Sensitivity and Pain Interference in Adolescents with Menstrual Pain: The Mediating Roles of Pain Catastrophizing and Fatigue

OBJECTIVE: Among adolescent girls, primary dysmenorrhea (ie,, menstrual pain without an identified underlying pathology) has been linked to heightened sensitivity to non-painful stimuli (eg,, light, touch, sound, etc.) and future widespread pain. However, less is known about how multisensory sensitivity is related to menstrual and non-menstrual pain interference, or which cognitive and psychophysiological factors contribute to these associations. This study examined the relationships between multisensory sensitivity and menstrual and non-menstrual pain interference, and whether pain catastrophizing or fatigue mediated these relationships. METHODS: One hundred thirty-eight female adolescents (mean age = 17.2, SD = 1.9) with varying levels of menstrual pain and no other chronic pain completed validated measures of menstrual and non-menstrual pain interference, multisensory sensitivity, pain catastrophizing, and fatigue. Mediation analyses were performed using the PROCESS macro in SPSS, controlling for corresponding pain severity ratings. RESULTS: : Multisensory sensitivity was associated with greater pain catastrophizing and fatigue, which, in turn, contributed to greater non-menstrual pain interference (combined indirect effect = 1.80, 95% CI[0.81,3.10]). There was no direct effect of multisensory sensitivity on menstrual pain interference (b = -0.20, 95% CI[-0.69,0.29]). CONCLUSIONS: These findings enhance our understanding of the cognitive and psychophysiological factors linking multisensory sensitivity and non-menstrual pain interference in adolescents with varying levels of menstrual pain severity. Our findings highlight the early functional impact of multisensory sensitivity, pain catastrophizing, and fatigue and an opportunity for earlier identification and intervention in an at-risk population.