Fillingim Roger B, Hastie Barbara A, Ness Timothy J, Glover Toni L, Campbell Claudia M, Staud Roland
University of Florida College of Dentistry, Public Health Services and Research, 1600 SW Archer Road, Room D8-44A, P.O. Box 100404, Gainesville, FL 32610-0404, USA.
Biol Psychol. 2005 Apr;69(1):97-112. doi: 10.1016/j.biopsycho.2004.11.008. Epub 2004 Dec 25.
Sex differences in pain perception and analgesic responses have garnered increasing attention in recent years. We examined the association of psychological factors to baseline pain perception and pentazocine analgesia among 49 healthy women and 39 men. Subjects completed psychological questionnaires measuring positive and negative affect as well as catastrophizing. Subsequently, responses to experimental pain were assessed before and after double-blind administration of intravenous pentazocine (0.5mg/kg). In correlational analyses, positive affect predicted lower pain sensitivity among men but not women. Negative affect predicted lower baseline pain tolerances among both sexes but predicted poorer analgesia only among men. Catastrophizing was associated with greater pain sensitivity and less analgesia more consistently in men than women. Regression models revealed that positive affect predicted lower overall pain sensitivity and catastrophizing predicted poorer overall analgesic responses among men, while no significant predictors of overall pain or analgesia emerged for women. Moreover, positive affect and catastrophizing were negatively and positively correlated, respectively, with side effects from the medication, but only among men. These findings indicate sex-dependent associations of psychological factors with baseline pain perception, analgesic responses, and medication side effects.
近年来，疼痛感知和镇痛反应中的性别差异受到了越来越多的关注。我们研究了49名健康女性和39名男性中，心理因素与基线疼痛感知及喷他佐辛镇痛效果之间的关联。受试者完成了测量积极和消极情绪以及灾难化思维的心理问卷。随后，在双盲静脉注射喷他佐辛（0.5mg/kg）前后，评估对实验性疼痛的反应。在相关性分析中，积极情绪预示男性而非女性的疼痛敏感性较低。消极情绪预示两性的基线疼痛耐受性较低，但仅预示男性的镇痛效果较差。与女性相比，灾难化思维在男性中更一致地与更高的疼痛敏感性和更低的镇痛效果相关。回归模型显示，积极情绪预示男性的总体疼痛敏感性较低，灾难化思维预示男性的总体镇痛反应较差，而女性未出现总体疼痛或镇痛的显著预测因素。此外，积极情绪和灾难化思维分别与药物副作用呈负相关和正相关，但仅在男性中如此。这些发现表明心理因素与基线疼痛感知、镇痛反应和药物副作用之间存在性别依赖性关联。
