May 16, 2024

Defying Prevailing Assumptions: People With Autism Are Not “Indifferent or Hypo-Sensitive” to Pain

Prof. Weissman-Fogel and associates performed extensive laboratory tests of discomfort perception in 104 grownups, 52 with autism. This sample is the largest as of yet testing discomfort psychophysics in autism. The two groups had comparable ratings on a brief cognitive test. People with autism had greater usage of psychiatric medications and rated themselves as having higher anxiety as well as greater sensitivity to discomfort and to everyday environmental stimuli (such as odor, light, and noise). This research job was funded by the Israel Science Foundation (ISF; 1005/17).
On quantitative sensory tests, there were no distinctions in thermal and pain detection thresholds between the autistic and non-autistic groups. This shows normal pain and thermal thresholds, suggesting “typical performance of the peripheral nervous system” amongst individuals with autism.
However, the autistic group provided regularly higher pain ratings in action to different stimuli above their pain threshold, proving pain hypersensitivity. The tests likewise provided evidence that people with autism can successfully inhibit brief discomfort stimuli but not long-lasting discomfort stimuli. Importantly, experiencing lasting discomfort in every day life is a risk aspect for establishing chronic discomfort.
New findings may result in early treatment and better quality of life
Together, the findings recommend that people with autism have a “pro-nociceptive” pain modulation profile: their brain appears more active in facilitating discomfort experience and less active in inhibiting continuous discomfort. This is consistent with the theory of excitatory/inhibitory imbalance as an underlying system of autism spectrum disorder– however one that has been overlooked in regards to discomfort processing.
The research study concerns the understanding that people with autism experience less discomfort, and instead suggests that they may have improved discomfort level of sensitivity. Prof. Weissman-Fogel and associates compose, “This misconception can cause late diagnosis and poor treatment triggering suffering and worsening the autistic symptoms”– potentially increasing the risk of establishing persistent pain conditions. While their research study focused on a group of autistic individuals with essentially typical cognitive function, the scientists write, “these outcomes might also use to individuals with autism whose spoken and cognitive communication problems might remove their capability to interact their pain.”
Prof. Weissman-Fogel and coauthors conclude: “These findings may raise parent, caretaker, and doctor awareness to the discomfort phenomenon in autism, and therefore result in reliable and early treatment to enhance the health and wellbeing and quality of life for autistic people and their households.”
Reference: “Indifference or hypersensitivity? Fixing the riddle of the pain profile in individuals with autism” by Tseelaa Hoffman, Tamib Bar-Shalita, Yelenad Granovsky, Eynatf Gal, Merryf Kalingel-Levi, Yaela Dori, Chend Buxbaum, Natalyag Yarovinsky and Irita Weissman-Fogel, 26 August 2022, PAIN.DOI: 10.1097/ j.pain.0000000000002767.

Autism is a neurodevelopmental condition that impacts communication, social interaction, and behavior. Research has actually revealed that people with autism might experience discomfort differently than neurotypical people.
According to a research study released in PAIN, the official journal of the International Association for the Study of Pain (IASP), people with autism might have normal discomfort limits but increased level of sensitivity to uncomfortable stimuli.
” This evidence demonstrating enhanced pain sensitivity warrants changing the typical belief that autistic individuals experience less pain,” according to the report by Professor Irit Weissman-Fogel of the University of Haifa, Israel, and associates. They believe their findings highlight the requirement for increased awareness, which might impact the effective treatment of pain in individuals with autism
New evidence concerns the assumptions about discomfort in autism.
The researchers aimed to check the “dominating presumption” that individuals with autism are hypo-sensitive to discomfort. Existing diagnostic criteria suggest that autistic people show “evident indifference” to pain or temperature. Yet most previous studies have actually not revealed differences in discomfort level of sensitivity in autistic people.

The autistic group gave regularly higher discomfort ratings in reaction to different stimuli above their discomfort threshold, proving pain hypersensitivity. The tests also provided evidence that individuals with autism can successfully prevent short pain stimuli however not long-lasting pain stimuli. Notably, experiencing long-lasting pain in daily life is a risk factor for establishing chronic discomfort.
The study concerns the perception that individuals with autism experience less pain, and rather recommends that they might have boosted pain level of sensitivity. While their study focused on a group of autistic people with essentially regular cognitive function, the scientists compose, “these outcomes may also apply to people with autism whose cognitive and verbal communication problems may remove their capability to communicate their pain.”