Chronic Overlapping Pain and Central Sensitization in Chronic Pelvic Pain: Do Positive and Negative Affect Play a Role?

Chronic pelvic pain (CPP) has a complex etiology and a high degree of coprevalence with other chronic overlapping pain conditions (COPCs). Evidence suggests that central sensitization contributes to these conditions; however, the psychological risk and resilience factors influencing the relationship between COPCs and central sensitization have received limited attention. Therefore, the aim of this study was to examine whether positive and negative affect moderate the relationship between COPCs and central sensitization in individuals with CPP. Participants (N = 197) completed the Central Sensitization Inventory and Positive and Negative Affect Schedule and self-reported the presence of diagnosed COPCs. Results indicated that greater symptoms of central sensitization were associated with a greater number of COPCs (p < 0.01). Higher levels of positive affect were related to lower central sensitization (p < 0.01) and fewer COPCs (p < 0.05), while higher negative affect was associated with greater central sensitization (p < 0.01). After controlling for pelvic pain duration, a greater number of COPCs were associated with greater central sensitization, but only among individuals with lower positive affect (p = 0.01). No significant moderation effects were observed for negative affect (p = 0.13). The findings from this cross-sectional study suggest that lower positive affect may have an adverse effect on central sensitization in those with a greater number of COPCs. Individuals with CPP, especially those experiencing multiple chronic pain conditions, may benefit from interventions aimed at increasing positive affect.