Tang Nicole K Y, Salkovskis Paul M, Poplavskaya Elena, Wright Kelly J, Hanna Magdi, Hester Joan
Department of Psychology (PO 77), Institute of Psychiatry, King's College London, de Crespigny Park, Denmark Hill, London SE5 8AF, UK.
Behav Res Ther. 2007 Dec;45(12):2821-35. doi: 10.1016/j.brat.2007.05.004. Epub 2007 May 18.
Many patients with chronic pain also exhibit elevated levels of health anxiety. This study examined the effect of health anxiety on the use of safety-seeking behaviors (SSBs) in pain-provoking situations. Participants were 20 chronic back pain patients with high health anxiety (Group H), 20 with low health anxiety (Group L) and 20 pain-free controls (Group C). Two physical tasks were video recorded, and compared both for overt pain behavior (identified by blind observers following a standardized procedure) and for the occurrence of SSB (identified by showing the participants video playback and asking them to specify motivation for all actions/behaviors displayed during the tasks). While there were no differences in the display of overt pain behaviors, Group H deployed a greater number of SSBs than Groups L and C. This finding held true for both tasks and remained significant when concurrent pain and mood ratings were statistically controlled for. SSB was correlated with catastrophizing thoughts but not pain intensity; pain intensity was correlated with overt pain behavior but not catastrophizing. Taken together, these findings suggest that SSB is distinct from overt pain behavior and may be a defining characteristic of chronic pain patients reporting high levels of health anxiety.
许多慢性疼痛患者还表现出较高水平的健康焦虑。本研究考察了健康焦虑对在引发疼痛的情境中使用寻求安全行为（SSB）的影响。参与者包括20名健康焦虑水平高的慢性背痛患者（H组）、20名健康焦虑水平低的患者（L组）和20名无疼痛的对照组（C组）。对两项身体任务进行了视频记录，并比较了明显的疼痛行为（由盲法观察者按照标准化程序识别）以及SSB的发生情况（通过向参与者播放视频回放并要求他们说明任务期间所展示的所有动作/行为的动机来识别）。虽然在明显疼痛行为的表现上没有差异，但H组比L组和C组使用了更多的SSB。这一发现对两项任务均成立，并且在对同时存在的疼痛和情绪评分进行统计学控制后仍然显著。SSB与灾难化思维相关，但与疼痛强度无关；疼痛强度与明显的疼痛行为相关，但与灾难化无关。综合来看，这些发现表明SSB与明显的疼痛行为不同，可能是报告高水平健康焦虑的慢性疼痛患者的一个决定性特征。
