Stress during the COVID-19 Pandemic Moderates Pain Perception and Momentary Oxytocin Levels

Ekaterina Schneider; Dora Hopf; Monika Eckstein; Dirk Scheele; Corina Aguilar-Raab; Sabine C Herpertz; Valery Grinevich; Beate Ditzen

doi:10.3390/jcm12062333

Stress during the COVID-19 Pandemic Moderates Pain Perception and Momentary Oxytocin Levels

J Clin Med. 2023 Mar 16;12(6):2333. doi: 10.3390/jcm12062333.

Authors

Ekaterina Schneider^{1

2}, Dora Hopf^{1

2}, Monika Eckstein^{1

2}, Dirk Scheele³, Corina Aguilar-Raab^{1

2}, Sabine C Herpertz⁴, Valery Grinevich⁵, Beate Ditzen^{1

2}

Affiliations

¹ Center for Psychosocial Medicine, Institute of Medical Psychology, Heidelberg University Hospital, Bergheimer Str. 20, 69115 Heidelberg, Germany.
² Institute of Psychology, Faculty of Behavioral and Cultural Studies, Heidelberg University, 69117 Heidelberg, Germany.
³ Department of Social Neuroscience, Faculty of Psychology, Ruhr-University Bochum, 44791 Bochum, Germany.
⁴ Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University Hospital, 69115 Heidelberg, Germany.
⁵ Department of Neuropeptide Research in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, 68159 Mannheim, Germany.

Abstract

Self-reported pain levels have been associated with increased stress levels during the COVID-19 pandemic. Less is known about the long-term effects of stress on individuals' physical and emotional pain levels and their associations with the neuropeptide hormone oxytocin. We aimed to predict momentary pain through individual stress levels and momentary oxytocin levels at genuinely high-stress phases, namely during COVID-related lockdowns. In a cross-sectional (n = 254) and a longitudinal (n = 196) assessment during lockdowns in Germany, participants completed a 2-day ecological momentary assessment (EMA) protocol (collecting six saliva samples on two consecutive days each and simultaneously reporting on stress, physical, and emotional pain levels) in 2020, as well as one year later, in 2021. Hierarchical linear modeling revealed significant positive associations between individuals' stress levels and physical pain, both cross-sectionally (b = 0.017; t(103) = 3.345; p = 0.001) and longitudinally (b = 0.009; t(110) = 2.025; p = 0.045). Similarly, subjective stress ratings showed significant positive associations with emotional pain on a within-person (b = 0.014; t(63) = 3.594; p < 0.001) as well as on a between-person (b = 0.026; t(122) = 5.191; p < 0.001) level. Participants further displayed significantly lower salivary oxytocin when experiencing higher levels of emotional pain (b = -0.120; t(163) = -2.493; p = 0.014). In addition, high-stress levels significantly moderated the association between physical pain and salivary oxytocin (b = -0.012; t(32) = -2.150; p = 0.039). Based on mechanistic and experimental research, oxytocinergic mechanisms have long been suggested to modulate pain experiences, however, this has not yet been investigated in everyday life. Our data, which was collected from a large sample experiencing continued stress, in this case, during the COVID-19 pandemic, suggests that individuals experience more intense physical pain and elevated stress levels, as shown by particularly low salivary oxytocin concentrations.

Keywords: COVID-19; ecological momentary assessment; emotional pain; oxytocin; physical pain; stress.

Abstract

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