无助感和感知疼痛强度：与健康年轻男性电刺激后皮质醇浓度的关系。
Helplessness and perceived pain intensity: relations to cortisol concentrations after electrocutaneous stimulation in healthy young men.
机构信息
Vitos Clinical Centre Giessen-Marburg Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy Giessen Academic Hospital, University of Giessen, Licher Straße 106, 35394 Giessen, Germany.
出版信息
Biopsychosoc Med. 2011 Jun 30;5:8. doi: 10.1186/1751-0759-5-8.
BACKGROUND
Uncontrollable aversive events are associated with feelings of helplessness and cortisol elevation and are suitable as a model of depression. The high comorbidity of depression and pain symptoms and the importance of controllability in both conditions are clinically well-known but empirical studies are scarce. The study investigated the relationship of pain experience, helplessness, and cortisol secretion after controllable vs. uncontrollable electric skin stimulation in healthy male individuals.
METHODS
Sixty-four male volunteers were randomly assigned to receive 30 controllable (self-administered) or uncontrollable (experimenter-administered) painful electric skin stimuli. Perceived pain intensity (PPI), subjective helplessness ratings, and salivary cortisol concentrations were assessed. PPI was assessed after stress exposure. For salivary cortisol concentrations and subjective helplessness ratings, areas under the response curve (AUC) were calculated.
RESULTS
After uncontrollable vs. controllable stress exposure significantly higher PPI ratings (P = 0.023), higher subjective helplessness AUC (P < 0.0005) and higher salivary cortisol AUC (P = 0.004, t-tests) were found. Correlation analyses revealed a significant correlation between subjective helplessness AUC and PPI (r = 0.500, P < 0.0005), subjective helplessness AUC and salivary cortisol AUC (r = 0.304, P = 0.015) and between PPI and salivary cortisol AUC (r = 0.298, P = 0.017).
CONCLUSIONS
The results confirm the impact of uncontrollability on stress responses in humans; the relationship of PPI with subjective helplessness and salivary cortisol suggests a cognitive-affective sensitization of pain perception, particularly under uncontrollable conditions.
背景
无法控制的厌恶事件会引起无助感和皮质醇升高，适合作为抑郁模型。抑郁和疼痛症状的高共病率以及两者条件下的可控性的重要性在临床上是众所周知的，但实证研究却很少。本研究调查了在健康男性个体中，可控与不可控电击皮肤刺激后疼痛体验、无助感和皮质醇分泌之间的关系。
方法
64 名男性志愿者被随机分配接受 30 次可控（自我施加）或不可控（实验者施加）的疼痛电击皮肤刺激。评估感知疼痛强度（PPI）、主观无助感评分和唾液皮质醇浓度。在应激暴露后评估 PPI。对于唾液皮质醇浓度和主观无助感评分，计算了反应曲线下面积（AUC）。
结果
与可控应激暴露相比，不可控应激暴露后 PPI 评分显著升高（P = 0.023），主观无助感 AUC 更高（P < 0.0005），唾液皮质醇 AUC 也更高（P = 0.004，t 检验）。相关分析显示，主观无助感 AUC 与 PPI 之间存在显著相关性（r = 0.500，P < 0.0005），主观无助感 AUC 与唾液皮质醇 AUC 之间存在显著相关性（r = 0.304，P = 0.015），PPI 与唾液皮质醇 AUC 之间也存在显著相关性（r = 0.298，P = 0.017）。
结论
这些结果证实了不可控性对人类应激反应的影响；PPI 与主观无助感和唾液皮质醇之间的关系表明，疼痛感知存在认知情感敏感化，尤其是在不可控条件下。
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