1 Journal of Psychosomatic Obstetrics & Gynecology, 2011; 1–6, Early Online Copyright © 2011 Informa UK, Ltd. ISSN 0167-482X print/ISSN 1743-8942 online DOI: 10.3109/0167482X.2011.626093 There has been a good deal of research on the role of anxiety sensitivity in pain perception, but only recently have investigators begun to assess its role in labor pain. The aim of this study was to investigate the nature of this relationship as well as the relationship of state and trait anxiety with labor pain. Assessments of maximum and average labor pain were completed in three different time periods (before, during and immediately after labor, and 1 month postpartum). Anxiety and anxiety sensitivity measures were completed during the late stage of pregnancy. A total of 46 primiparous healthy pregnant women, carrying a single child, participated in the study. State anxiety correlated significantly with maximum (r = 0.352, p < 0.01) and average (r = 0.325, p < 0.05) labor pain expectancies, whereas trait anxiety correlated significantly with maximum labor pain expectancies (r = 0.306, p < 0.05). During labor, only the physical concerns dimension of anxiety sensitivity shared a significant relationship with sensory pain (r = 0.292, p < 0.05). In conclusion, anxiety shares a significant relationship with labor pain expectancies only, whereas the physical concerns dimension of anxiety sensitivity correlates significantly with sensory pain during labor. These data clarify the role of anxiety and anxiety sensitivity in the experience of labor pain. Clinical implications are discussed. Keywords: Anxiety, anxiety sensitivity, childbirth, pain Introduction Trait anxiety, defined as a stable tendency to respond with state anxiety in the anticipation of threatening situations, is commonly proposed as one of the main psychological factors contributing to higher labor pain intensity [1,2]. Yet, studies have thus far failed to obtain consistent data to support this hypothesis [3,4]. Moreover, Lang et al [4]. suggest that labor pain may not be influenced by trait anxiety, but rather by the woman’s fear that those experiences of pain are threatening and harmful. In other words, anxiety sensitivity, defined as a tendency to fear anxiety-related symptoms due to the belief that there will be some negative outcome as a result of hav- ing those symptoms, may be a factor significantly related to labor pain. In this single research study [4] that investigated the role of anxiety sensitivity in labor pain, the authors found that anxiety sensitivity shared a significant relationship with maximum sensory and affective labor pain, but that state and trait anxiety (measured by the state-trait anxiety inven- tory (STAI)) did not correlate significantly with labor pain. Anxiety sensitivity predicted both maximum pain during labor and sensory aspects of pain above and beyond demo- graphic and social factors as well as other theoretically impor- tant psychological factors (e.g. depression and state anxiety). Similar results were obtained by Spice et al. [5], who found that anxiety sensitivity significantly predicted elevated fear of childbirth even aſter controlling for parity and trait anxiety. Currently, Norton and Asmundson’s amended fear-avoid- ance model [6] provides the best explanation for why anxiety sensitivity seems to contribute to higher labor pain intensi- ties. ey argue that symptoms of physiological arousal (e.g. increased heart rate, increased blood flow to voluntary mus- cles) may produce bodily sensations such as muscular tension that elicit misinterpretations of the nature and meaning of the sensations. ese misinterpretations are seen as the product of individual differences in the propensity to respond with fear to sensations that are anxiety provoking (e.g. anxiety sensitiv- ity and/or negative affect). ose with high anxiety sensitivity will catastrophically misinterpret the physiological sensations of anxiety, provoked by the anticipation of, or exposure to, a pain-provoking situation, as evidence of impending harm and/or pain [7]. In turn, these catastrophically misinterpreted bodily sensations can lead to the avoidance of associated situ- ations. Indeed, research has demonstrated that women who are prone to pain anticipated and experienced more intense labor pain and had poorer postpartum physical recovery [8]. ORIGINAL ARTICLE Anxiety sensitivity and anxiety as correlates of expected, experienced and recalled labor pain Doris Curzik 1 & Natasa Jokic-Begic 2 1 Department of Psychiatry, University Hospital Center Zagreb, Croatia, and 2 Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia Correspondence: Dr. Natasa Jokic-Begic PhD., Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, I. Lucica 3, Zagreb, 1000 Croatia. E-mail: njbegic@ffzg.hr J Psychosom Obstet Gynaecol Downloaded from informahealthcare.com by 93.139.18.91 on 10/31/11 For personal use only.