Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
Eur J Pain. 2010 Apr;14(4):434-40. doi: 10.1016/j.ejpain.2009.07.003. Epub 2009 Aug 8.
Patients with work-related upper extremity pain (WRUED) experience disability in daily life activities. The factors that influence levels of disability are still unclear. Both excessive avoidance and persistence have been suggested, but the affective and motivational processes that underlie these behaviours have not been scrutinized. This study was aimed at examining the role of current mood and stop rules on physical task performance, controlling for gender, pain severity, pain catastrophizing, and pain-related fear. An additional focus was the role of the interaction between current mood and stop rules as predicted by the novel Mood-as-Input (MAI) model. Following MAI, it is the informational value of current mood within a goal context (stop rule), rather than mood per se that predicts behaviour. A 2 (mood)x2 (stop rule)x2 (physical task order) factorial design was used in which 62 WRUED patients performed an upper and lower extremity physical task. A stress interview was used to induce positive and negative mood. Patients received either an "as-much-as-can (AMAC)" stop rule instruction, or a "feel-like-discontinuing (FLDC)" stop rule instruction. Results showed that physical task performance was predicted by pain-related fear, current mood, stop rule. However, the predicted moodxstop rule interaction was not found, and there was no influence of gender, pain severity, and pain catastrophizing on task performance. The findings suggest that not only pain-related fear, but current mood and goal context factors independently affect physical performance in patients with WRUED.
患有与工作相关的上肢疼痛（WRUED）的患者在日常生活活动中会出现残疾。影响残疾程度的因素尚不清楚。过度回避和坚持都有被提出，但支持这些行为的情感和动机过程尚未被仔细研究。本研究旨在检查当前情绪和停止规则对身体任务表现的作用，同时控制性别、疼痛严重程度、疼痛灾难化和与疼痛相关的恐惧。另外一个重点是当前情绪和停止规则之间的相互作用的作用，这是由新颖的情绪作为输入（MAI）模型预测的。根据 MAI，预测行为的是目标环境（停止规则）内当前情绪的信息价值，而不是情绪本身。使用 2（情绪）x2（停止规则）x2（物理任务顺序）的因子设计，其中 62 名 WRUED 患者执行上肢和下肢物理任务。使用压力访谈来诱发积极和消极情绪。患者收到“尽可能多（AMAC）”停止规则指令或“感觉需要停止（FLDC）”停止规则指令。结果表明，物理任务表现受疼痛相关恐惧、当前情绪和停止规则预测。然而，未发现预期的情绪 x 停止规则的相互作用，并且性别、疼痛严重程度和疼痛灾难化对任务表现没有影响。研究结果表明，不仅疼痛相关恐惧，而且当前情绪和目标环境因素独立影响 WRUED 患者的身体表现。
