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更大的倾向性乐观与较少的内源性疼痛易化之间的关联,是通过较低水平的疼痛灾难化而间接传递的。

The association of greater dispositional optimism with less endogenous pain facilitation is indirectly transmitted through lower levels of pain catastrophizing.

机构信息

University of Alabama at Birmingham, College of Arts and Sciences, Department of Psychology, Birmingham, Alabama 35294, USA.

出版信息

J Pain. 2013 Feb;14(2):126-35. doi: 10.1016/j.jpain.2012.10.007. Epub 2012 Dec 4.

Abstract

UNLABELLED

Dispositional optimism has been shown to beneficially influence various experimental and clinical pain experiences. One possibility that may account for decreased pain sensitivity among individuals who report greater dispositional optimism is less use of maladaptive coping strategies such as pain catastrophizing, a negative cognitive/affective response to pain. An association between dispositional optimism and conditioned pain modulation, a measure of endogenous pain inhibition, has previously been reported. However, it remains to be determined whether dispositional optimism is also associated with temporal summation (TS), a measure of endogenous pain facilitation. The current study examined whether pain catastrophizing mediated the association between dispositional optimism and TS among 140 older, community-dwelling adults with symptomatic knee osteoarthritis. Individuals completed measures of dispositional optimism and pain catastrophizing. TS was then assessed using a tailored heat pain stimulus on the forearm. Greater dispositional optimism was significantly related to lower levels of pain catastrophizing and TS. Bootstrapped confidence intervals revealed that less pain catastrophizing was a significant mediator of the relation between greater dispositional optimism and diminished TS. These findings support the primary role of personality characteristics such as dispositional optimism in the modulation of pain outcomes by abatement of endogenous pain facilitation and less use of catastrophizing.

PERSPECTIVE

Results from this study further support the body of evidence that attests to the beneficial effects of positive personality traits on pain sensitivity and pain processing. Further, this study identified diminished pain catastrophizing as an important mechanism explaining the inverse relation between dispositional optimism and endogenous pain facilitation.

摘要

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性格倾向乐观已被证明能对各种实验性和临床疼痛体验产生有益影响。性格倾向乐观的个体报告的疼痛敏感性降低,这可能归因于他们较少使用适应性应对策略,如对疼痛的消极认知/情感反应——疼痛灾难化。性格倾向乐观与条件疼痛调制(一种内源性疼痛抑制的测量方法)之间先前已有关联。然而,性格倾向乐观是否也与时间总和(一种内源性疼痛促进的测量方法)有关,这仍有待确定。目前的研究检验了在 140 名有症状的膝关节骨关节炎的老年社区居民中,性格倾向乐观与时间总和之间是否存在疼痛灾难化的中介作用。个体完成了性格倾向乐观和疼痛灾难化的测量。然后在手前臂上使用定制的热痛刺激来评估时间总和。性格倾向乐观与疼痛灾难化水平较低显著相关,与时间总和较高负相关。引导置信区间显示,疼痛灾难化程度较低是性格倾向乐观与时间总和降低之间关系的一个重要中介。这些发现支持了人格特征(如性格倾向乐观)在调节疼痛结果方面的主要作用,即减轻内源性疼痛促进作用和减少灾难化的使用。

观点

本研究的结果进一步支持了越来越多的证据,这些证据证明了积极的人格特征对疼痛敏感性和疼痛处理有益的影响。此外,本研究还确定了疼痛灾难化程度降低是解释性格倾向乐观与内源性疼痛促进之间负相关关系的一个重要机制。

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