A complete component analysis of Stress Inoculation for pain tolerance

This study involved a complete component analysis of Stress Inoculation Training (SIT) for the reduction of cold pressor pain. SIT consists of an Education, Skills Acquisition, and Application phase. Each of these three phases alone, all possible pairs of phases, the complete protocol, and a pseudotreatment control were presented to groups of university women. While the complete protocol increased pain tolerance relative to the control protocol, not all of the phases of SIT were found to be important to the package. Only the Skills Acquisition phase played an important role in the SIT package. That is, when the Skills Acquisition phase was dropped from the package, the efficacy of SIT was significantly lower. While the Education phases increased pain tolerance when presented alone, it did not appear to add to the efficacy of the total package. The Application phase was ineffective for increasing tolerance by itself and did not add to the efficacy of SIT. Further data suggested that the effects of the Skills Acquisition phase might be mediated by increased use of relaxation and/or by a decrease in catastrophizing. Self-instructions were not readily employed and may not be important in increasing tolerance in the analogue context. These findings question the multidimensional training approach to SIT for analogue pain, as well as the focus on the role of self-instructions within the SIT package.