Khatibi Ali, Dehghani Mohsen, Sharpe Louise, Asmundson Gordon J G, Pouretemad Hamidreza
Department of Psychology, Shahid Beheshti University, G. C., Tehran, Iran.
Pain. 2009 Mar;142(1-2):42-7. doi: 10.1016/j.pain.2008.11.020. Epub 2009 Feb 6.
Evidence that patients with chronic pain selectively attend to pain-related stimuli presented in modified Stroop and dot-probe paradigms is mixed. The pain-related stimuli used in these studies have been primarily verbal in nature (i.e., words depicting themes of pain). The purpose of the present study was to determine whether patients with chronic pain, relative to healthy controls, show selective attention for pictures depicting painful faces. To do so, 170 patients with chronic pain and 40 age- and education-matched healthy control participants were tested using a dot-probe task in which painful, happy, and neutral facial expressions were presented. Selective attention was denoted using the mean reaction time and the bias index. Results indicated that, while both groups shifted attention away from happy faces (and towards neutral faces), only the control group shifted attention away from painful faces. Additional analyses were conducted on chronic pain participants after dividing them into groups on the basis of fear of pain/(re)injury. The results of these analyses revealed that while chronic pain patients with high and low levels of fear both shifted attention away from happy faces, those with low fear shifted attention away from painful faces, whereas those with high fear shifted attention towards painful faces. These results suggest that patients with chronic pain selectively attend to facial expressions of pain and, importantly, that the tendency to shift attention towards such stimuli is positively influenced by high fear of pain/(re)injury. Implications of the findings and future research directions are discussed.
在改良的斯特鲁普（Stroop）和点探测范式中，慢性疼痛患者是否会选择性地关注与疼痛相关的刺激，相关证据并不一致。这些研究中使用的与疼痛相关的刺激主要是语言性质的（即描述疼痛主题的词语）。本研究的目的是确定与健康对照组相比，慢性疼痛患者是否会对描绘痛苦表情的图片表现出选择性关注。为此，对170名慢性疼痛患者和40名年龄及教育程度匹配的健康对照参与者进行了点探测任务测试，其中呈现了痛苦、快乐和中性的面部表情。使用平均反应时间和偏差指数来表示选择性关注。结果表明，虽然两组都将注意力从快乐表情上转移开（转向中性表情），但只有对照组将注意力从痛苦表情上转移开。在根据对疼痛/（再）受伤的恐惧将慢性疼痛参与者分组后，对他们进行了进一步分析。这些分析结果显示，虽然恐惧程度高和低的慢性疼痛患者都将注意力从快乐表情上转移开，但恐惧程度低的患者将注意力从痛苦表情上转移开，而恐惧程度高的患者则将注意力转向痛苦表情。这些结果表明，慢性疼痛患者会选择性地关注痛苦的面部表情，重要的是，将注意力转向此类刺激的倾向受到对疼痛/（再）受伤的高度恐惧的积极影响。本文讨论了研究结果的意义和未来的研究方向。
