George Steven Z, Dannecker Erin A, Robinson Michael E
Department of Physical Therapy, Brooks Center for Rehabilitation Studies, University of Florida, USA.
Eur J Pain. 2006 Jul;10(5):457-65. doi: 10.1016/j.ejpain.2005.06.007. Epub 2005 Aug 10.
Previous studies of the Fear-Avoidance Model of Exaggerated Pain Perception have commonly included patients with chronic low back pain, making it difficult to determine which psychological factors led to the development of an "exaggerated pain perception". This study investigated the validity of the Fear-Avoidance Model of Exaggerated Pain Perception by considering the influence of fear of pain and pain catastrophizing on acute pain perception, after considering sex and anxiety. Thirty-two males and 34 females completed the State-Trait Anxiety Inventory, the Fear of Pain Questionnaire, and the Coping Strategies Questionnaire. Subjects underwent a cold pressor procedure and tolerance, pain intensity, and blood pressure reactivity were measured. Sex, anxiety, fear of pain, and pain catastrophizing were simultaneously entered into separate multiple regression models to predict different components of pain perception. Tolerance was not predicted by fear of pain, pain catastrophizing, or anxiety. Pain intensity at threshold and tolerance were significantly predicted by fear of pain, only. Blood pressure reactivity to pain was significantly predicted by anxiety, only. These results suggest that fear of pain may have a stronger influence on acute pain intensity when compared to pain catastrophizing, while neither of the factors predicted tolerance or blood pressure reactivity.
先前关于夸大疼痛感知的恐惧-回避模型的研究通常纳入慢性下腰痛患者，这使得难以确定哪些心理因素导致了“夸大疼痛感知”的形成。本研究在考虑性别和焦虑因素后，通过考量疼痛恐惧和疼痛灾难化对急性疼痛感知的影响，探究了夸大疼痛感知的恐惧-回避模型的有效性。32名男性和34名女性完成了状态-特质焦虑量表、疼痛恐惧问卷和应对策略问卷。受试者接受冷加压程序，并测量其耐受性、疼痛强度和血压反应性。将性别、焦虑、疼痛恐惧和疼痛灾难化同时纳入单独的多元回归模型，以预测疼痛感知的不同组成部分。疼痛恐惧、疼痛灾难化或焦虑均无法预测耐受性。仅疼痛恐惧能显著预测阈值时的疼痛强度和耐受性。仅焦虑能显著预测对疼痛的血压反应性。这些结果表明，与疼痛灾难化相比，疼痛恐惧可能对急性疼痛强度有更强的影响，而这两个因素均无法预测耐受性或血压反应性。
