Hirsh Adam T, George Steven Z, Bialosky Joel E, Robinson Michael E
Center for Pain Research and Behavioral Health, University of Florida, Gainesville, Florida, USA.
J Pain. 2008 Sep;9(9):806-12. doi: 10.1016/j.jpain.2008.03.012. Epub 2008 May 16.
Pain-related fear and catastrophizing are important variables of consideration in an individual's pain experience. Methodological limitations of previous studies limit strong conclusions regarding these relationships. In this follow-up study, we examined the relationships between fear of pain, pain catastrophizing, and experimental pain perception. One hundred healthy volunteers completed the Fear of Pain Questionnaire (FPQ-III), Pain Catastrophizing Scale (PCS), and Coping Strategies Questionnaire-Catastrophizing scale (CSQ-CAT) before undergoing the cold pressor test (CPT). The CSQ-CAT and PCS were completed again after the CPT, with participants instructed to complete these measures based on their experience during the procedure. Measures of pain threshold, tolerance, and intensity were collected and served as dependent variables in separate regression models. Sex, pain catastrophizing, and pain-related fear were included as predictor variables. Results of regression analyses indicated that after controlling for sex, pain-related fear was a consistently stronger predictor of pain in comparison to catastrophizing. These results were consistent when separate measures (CSQ-CAT vs PCS) and time points (pretask vs "in vivo") of catastrophizing were used. These findings largely corroborate those from our previous study and are suggestive of the absolute and relative importance of pain-related fear in the experimental pain experience.
Although pain-related fear has received less attention in the experimental literature than pain catastrophizing, results of the current study are consistent with clinical reports highlighting this variable as an important aspect of the experience of pain.
与疼痛相关的恐惧和灾难化思维是个体疼痛体验中需要考虑的重要变量。以往研究的方法局限性限制了我们就这些关系得出强有力的结论。在这项随访研究中,我们考察了疼痛恐惧、疼痛灾难化思维与实验性疼痛感知之间的关系。100名健康志愿者在接受冷加压试验(CPT)前完成了疼痛恐惧问卷(FPQ-III)、疼痛灾难化量表(PCS)和应对策略问卷 - 灾难化分量表(CSQ-CAT)。在CPT后再次完成CSQ-CAT和PCS,要求参与者根据他们在该过程中的体验完成这些量表。收集疼痛阈值、耐受性和强度的测量数据,并将其作为单独回归模型中的因变量。将性别、疼痛灾难化思维和与疼痛相关的恐惧作为预测变量。回归分析结果表明,在控制性别因素后,与灾难化思维相比,与疼痛相关的恐惧始终是疼痛更强有力的预测因素。当使用灾难化思维的不同测量量表(CSQ-CAT与PCS)和时间点(任务前与“实时”)时,这些结果是一致的。这些发现很大程度上证实了我们之前研究的结果,并表明与疼痛相关的恐惧在实验性疼痛体验中的绝对和相对重要性。
尽管与疼痛相关的恐惧在实验文献中受到的关注少于疼痛灾难化思维,但本研究结果与临床报告一致,这些报告强调该变量是疼痛体验的一个重要方面。