Nikendei Christoph, Waldherr Sina, Schiltenwolf Marcus, Herzog Wolfgang, Röhrig Miriam, Walther Stephan, Weisbrod Matthias, Henningsen Peter, Hanel Gertraud
Department of Psychosomatic and General Clinical Medicine, University Hospital, University of Heidelberg, 69120 Heidelberg, Germany.
J Psychosom Res. 2009 Sep;67(3):199-206. doi: 10.1016/j.jpsychores.2009.01.017. Epub 2009 Apr 1.
Somatoform disorders are characterized by patterns of persistent bodily complaints. Organic illness attributions are assumed to represent a central supporting factor in the development and maintenance of somatoform disorders. Using group control design, we aimed to investigate the processing of illness-belief-related word stimuli in somatoform pain disorder patients.
Organic-related, psychosocial-related, and neutral word stimuli were presented to 14 somatoform pain patients with a predominantly organic illness attribution, 14 somatoform pain patients with a predominantly psychosocial illness attribution, and 14 control participants. Behavioral measures were taken during free recall and recognition tasks.
Our study revealed cognitive impairment in somatoform pain patients with an organic attribution of pain symptoms as compared to somatoform pain patients with a psychosocial attribution and healthy controls in both free recall test and recognition test. However, selective processing of word stimuli was not observed for patient groups.
We conclude that the observed impairment of memory performance in somatoform pain patients with an organic illness attribution may play an important role in the illness behavior of this patient group and ultimately result in the maintenance of symptoms and a more critical clinical outcome.
躯体形式障碍的特征是持续存在身体不适的模式。器质性疾病归因被认为是躯体形式障碍发生和维持的核心支持因素。采用组间对照设计,我们旨在研究躯体形式疼痛障碍患者对与疾病信念相关的词语刺激的加工情况。
向14名主要将疼痛归因于器质性疾病的躯体形式疼痛患者、14名主要将疼痛归因于心理社会因素的躯体形式疼痛患者和14名对照参与者呈现与器质性疾病相关、心理社会相关和中性的词语刺激。在自由回忆和识别任务期间进行行为测量。
我们的研究显示,在自由回忆测试和识别测试中,与主要将疼痛归因于心理社会因素的躯体形式疼痛患者及健康对照相比,主要将疼痛归因于器质性疾病的躯体形式疼痛患者存在认知障碍。然而,未观察到患者组对词语刺激的选择性加工。
我们得出结论,在主要将疼痛归因于器质性疾病的躯体形式疼痛患者中观察到的记忆表现受损,可能在该患者群体的疾病行为中起重要作用,并最终导致症状的维持和更严重的临床结局。