Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan Department of Rehabilitation Medicine, University of Washington School of Medicine, Box 356490, Seattle, WA, USA Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashiku, Fukuoka 812-8582, Japan.
Pain. 2010 May;149(2):273-277. doi: 10.1016/j.pain.2010.02.012. Epub 2010 Mar 5.
Alexithymia, the inability to identify or label emotions, has been shown to be associated with pain in patients with a number of chronic pain conditions. We sought to: (1) replicate this association in samples of persons with chronic pain secondary to neuromuscular disease, (2) extend this finding to other important pain-related measures, and (3) to determine whether relationships among alexithymia and study variables existed after controlling for negative affect. One hundred and twenty-nine individuals with muscular dystrophy and chronic pain were administered measures of alexithymia (Toronto Alexithymia Scale, TAS-20), pain intensity (0-10 NRS), pain interference (Brief Pain Inventory Interference scale), mental health (SF-36 Mental Health scale; as a proxy measure of negative affect) and vitality (SF-36 Vitality scale). Higher TAS scores were associated significantly with higher pain intensity and interference, and less vitality. Although the strengths of these associations were reduced when mental health was used as a control, the associations between the Difficulty Identifying Feelings scale and vitality, and the Externally Oriented Thinking and Total TAS scales and pain intensity remained statistically significant. The findings replicate and extend previous findings concerning the associations between alexithymia and important pain-related variables in a sample of persons with chronic pain and neuromuscular disease. Future research is needed to determine the extent to which the associations are due to (1) a possible causal effect of alexithymia on patient functioning that is mediated via its effects on negative affect or (2) the possibility that alexithymia/outcome relationships reflect response bias caused by general negative affectivity.
述情障碍，即无法识别或标记情绪，已被证明与许多慢性疼痛疾病患者的疼痛有关。我们试图：（1）在患有神经肌肉疾病引起的慢性疼痛的人群样本中复制这种关联；（2）将这一发现扩展到其他重要的与疼痛相关的测量指标；（3）确定在控制负性情绪后，述情障碍与研究变量之间的关系是否存在。129 名患有肌肉疾病和慢性疼痛的患者接受了述情障碍（多伦多述情障碍量表，TAS-20）、疼痛强度（0-10 NRS）、疼痛干扰（简明疼痛量表干扰量表）、心理健康（SF-36 心理健康量表；作为负性情绪的替代测量指标）和活力（SF-36 活力量表）的测量。TAS 得分越高，疼痛强度和干扰越大，活力越低。虽然当使用心理健康作为对照时，这些关联的强度会降低，但 Difficulty Identifying Feelings 量表与活力之间，以及 Externally Oriented Thinking 和 Total TAS 量表与疼痛强度之间的关联仍然具有统计学意义。这些发现复制并扩展了之前关于述情障碍与慢性疼痛和神经肌肉疾病患者重要疼痛相关变量之间关联的研究结果。需要进一步研究以确定述情障碍与患者功能之间的关联在多大程度上是由于（1）述情障碍对负性情绪的影响，从而对患者功能产生可能的因果影响，或者（2）述情障碍/结果关系反映了由一般负性情绪引起的反应偏差。
