Quartana Phillip J, Burns John W, Lofland Kenneth R
Department of Psychology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.
J Behav Med. 2007 Jun;30(3):221-31. doi: 10.1007/s10865-007-9101-z. Epub 2007 Apr 19.
In the present study, we examined whether experimentally-manipulated attentional strategies moderated relations between pain catastrophizing and symptom-specific physiological responses to a cold-pressor task among sixty-eight chronic low back patients. Patients completed measures of pain catastrophizing and depression, and were randomly assigned to sensory focus, distraction or suppression conditions during a cold pressor. Lumbar paraspinal and trapezius EMG, and cardiovascular responses to the cold pressor were assessed. Attentional strategies moderated the relation between pain catastrophizing and lumbar paraspinal muscle, but not trapezius muscle or cardiovascular responses. Only for participants in the suppression condition was catastrophizing related significantly to lumbar paraspinal muscle responses. Depressed affect did not account for this relation. These findings indicate that 'symptom-specific' responses among pain catastrophizers with chronic low back depend on how they attend to pain-related information. Specifically, it appears that efforts to suppress awareness of pain exaggerate muscular responses near the site of injury.
在本研究中，我们调查了在68名慢性下背痛患者中，通过实验操控的注意力策略是否会调节疼痛灾难化与对冷加压任务的症状特异性生理反应之间的关系。患者完成了疼痛灾难化和抑郁的测量，并在冷加压过程中被随机分配到感觉聚焦、分散注意力或抑制条件组。评估了腰部椎旁肌和斜方肌的肌电图以及对冷加压的心血管反应。注意力策略调节了疼痛灾难化与腰部椎旁肌之间的关系，但未调节与斜方肌或心血管反应之间的关系。仅对于处于抑制条件组的参与者，灾难化与腰部椎旁肌反应显著相关。抑郁情绪并不能解释这种关系。这些发现表明，慢性下背痛的疼痛灾难化者的“症状特异性”反应取决于他们对疼痛相关信息的关注方式。具体而言，抑制疼痛意识的努力似乎会夸大损伤部位附近的肌肉反应。
