Rhudy Jamie L, Dubbert Patricia M, Parker Jefferson D, Burke Randy S, Williams Amy E
The University of Tulsa, 600 South College, Tulsa, OK 74104, USA.
Pain Med. 2006 Nov-Dec;7(6):483-500. doi: 10.1111/j.1526-4637.2006.00237.x.
Prior work suggests that positive affect inhibits pain while negative affect facilitates it. The current study sought to determine whether: 1) affective modulation of pain extends to a patient population; 2) cocaine and alcohol dependence influences the pattern of modulation; and 3) affective modulation of pain is mediated by changes in arm temperature.
Thirty-seven participants with and without substance dependence (14 alcohol, 13 cocaine, 10 none) attended three experimental sessions intended to induce emotions (negative, neutral, positive) by picture-viewing. Following emotion-induction, participants were asked to submerge their arm in 33 degrees F water and keep it there until they reached tolerance. During submersion, pain ratings were made on a mechanical visual analog scale (M-VAS).
Latency from submersion to first movement of the M-VAS (pain threshold) and latency to arm removal (pain tolerance) were measured. Arm temperature and manipulation checks for emotion-induction (corrugator electromyogram, heart rate, skin conductance, self-report) were also recorded.
Manipulation checks confirmed that targeted affective states were achieved. Pain threshold and tolerance were higher after viewing pleasant pictures than after unpleasant ones. Although arm temperature did vary based on the affect induced, analyses suggested that temperature did not influence pain outcomes.
Affect modulates pain perception in patients and does not appear to be mediated by changes in arm temperature. Additionally, pain modulation was not significantly influenced by cocaine or alcohol dependence. These data are encouraging, because they suggest that nonpharmacological methods of pain modulation may be effective in substance-dependent individuals.
先前的研究表明，积极情绪抑制疼痛，而消极情绪则加剧疼痛。本研究旨在确定：1）疼痛的情感调节是否适用于患者群体；2）可卡因和酒精依赖是否会影响调节模式；3）疼痛的情感调节是否由手臂温度的变化介导。
37名有或无物质依赖的参与者（14名酒精依赖者、13名可卡因依赖者、10名无物质依赖者）参加了三个实验环节，通过观看图片来诱发情绪（消极、中性、积极）。情绪诱发后，要求参与者将手臂浸入33华氏度的水中并保持在那里，直到他们达到耐受极限。在浸入过程中，使用机械视觉模拟量表（M-VAS）进行疼痛评分。
测量从浸入到M-VAS首次移动的潜伏期（疼痛阈值）和手臂移出的潜伏期（疼痛耐受）。还记录了手臂温度以及情绪诱发的操作检查指标（皱眉肌肌电图、心率、皮肤电导、自我报告）。
操作检查证实达到了目标情感状态。观看愉快图片后的疼痛阈值和耐受度高于观看不愉快图片后。尽管手臂温度确实因诱发的情绪而有所变化，但分析表明温度并未影响疼痛结果。
情感调节患者的疼痛感知，且似乎不是由手臂温度的变化介导的。此外，疼痛调节并未受到可卡因或酒精依赖的显著影响。这些数据令人鼓舞，因为它们表明非药物性疼痛调节方法可能对物质依赖个体有效。
