A new investigation that has evaluated the perception of pain of people with autism spectrum disorders (ASD) has found that they experience a greater intensity of pain and that it is more difficult for them to adapt to this sensation than the general population. People with autism have difficulties relating to and expressing their feelings, which is why they are not always capable of expressing sensations such as pain. For this reason, the authors of the study hope that their findings will contribute to improving the approach to pain in these patients.
One of the features included in the current criteria for the diagnosis of autism is indifference to pain, notes Tami Bar-Shalita, MD, of the TAU Sackler School of Medicine and one of the study authors, adding: “Supposedly, proof of this was their tendency to inflict pain on themselves by self-harm. But this assumption is not necessarily true. We know that self-injury can stem from attempts to suppress pain, and it may be that self-injury is unconsciously activating a physical “pain-inhibiting pain” mechanism.
The researcher explained that approximately 10% of the population has a disorder known as sensory modulation dysfunction, which is characterized by sensory hypersensitivity at a level that interferes with the ability to perform daily activities and impairs quality of life. Those affected have difficulty, for example, ignoring or adjusting to the hum of fluorescent lights or air conditioners, or the “crunching of popcorn from someone sitting next to her in the theater.”
“Sensitivity to pain in people with autism is higher than that of the majority of the population, while, at the same time, they fail to effectively suppress painful stimuli”
Sensory modulation dysfunction affects between 70 and 90% of individuals with autism, is considered a criterion for its diagnosis, and is also associated with its severity. Previous studies had also revealed that people with this disorder experience more pain.
Hypersensitivity to pain in people with autism
The authors of the new study have explained that for many years it has been thought that people with autism experienced less pain or were indifferent to pain. His research has consisted of a laboratory pain study approved by the ethics committee of the academic institutions and Rambam in which 52 adults with high-functioning autism and normal intelligence have participated. The researchers used psychophysical tests to assess pain that allowed them to examine the link between stimulus and response, while a computer controlled the duration and intensity of the stimulus.
Participants were asked to rate the intensity of the pain they felt on a scale of 0 to 100, and the results have shown that people with autism suffer more pain and their pain suppression mechanism is less effective. The results have been published in the journal Pain.
The researchers carried out various measurements aimed at verifying whether the origin of the hypersensitivity to pain is in a sensitized nervous system, or if it is due to the suppression of mechanisms that would allow its adjustment and, over time, diminish the response to pain. “We found that, for people with autism, it’s a combination of the two: an increased pain signal coupled with a less effective pain inhibition mechanism,” Bar-Shalita said.
“The results indicate that, in most cases, pain sensitivity in people with autism is actually higher than that of the majority of the population, while, at the same time, they fail to effectively suppress pain. painful stimuli. We hope that our findings will help the professionals who manage this population and contribute to the advancement of personalized treatment”, he concludes.
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