Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA Department of Psychology, Kent State University, Kent, OH, USA Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Pain. 2013 Oct;154(10):2045-2053. doi: 10.1016/j.pain.2013.06.023. Epub 2013 Jun 19.
The current study applied a model of pain communication to examine the distinction between verbal and nonverbal pain expression in their prediction of punishing, empathic, and solicitous spouse responses to patient pain. It was hypothesized that on days when patients engaged in more nonverbal expression, spouses would respond more positively (ie, with less punishing and more solicitous and empathic behavior). The same pattern was predicted for verbal expression. In addition, it was expected that associations between patient nonverbal pain expression and positive spouse responses would be strengthened, and that the association with punishing responses would be weakened, on days when levels of verbal pain expression were higher than usual, regardless of daily pain severity. In a 22-day diary study, 144 individuals with knee osteoarthritis and their spouses completed daily measures of pain expression, spouse responses, health, and affect. The predicted positive main effect of nonverbal expression on empathic and solicitous responses was supported by the data, as was the positive main effect for verbal pain expression. Results from moderation analyses partially supported our hypothesis in that patients' nonverbal pain expression was even more strongly related to empathic and solicitous spouse responses on days of high verbal pain expression, and patients were buffered from spouse punishing responses on days when both nonverbal and verbal expression were high. These findings suggest that pain expression in both verbal and nonverbal modes of communication is important for positive and negative spousal responses.
本研究应用疼痛沟通模型，考察了言语和非言语疼痛表达在预测配偶对患者疼痛的惩罚、共情和关心反应中的区别。假设患者在非言语表达上的参与度增加，配偶的反应会更加积极（即惩罚行为减少，共情和关心行为增多）。这一模式同样适用于言语表达。此外，预计在言语疼痛表达水平高于日常水平的日子里，患者的非言语疼痛表达与配偶积极反应之间的关联将得到加强，而与惩罚反应之间的关联将减弱，无论日常疼痛严重程度如何。在一项为期 22 天的日记研究中，144 名膝骨关节炎患者及其配偶每天完成疼痛表达、配偶反应、健康和情绪的测量。数据支持了非言语表达对共情和关心反应的积极主要影响，言语疼痛表达也有同样的积极主要影响。调节分析的结果部分支持了我们的假设，即患者的非言语疼痛表达在言语疼痛表达较高的日子里与共情和关心配偶的反应更密切相关，而在非言语和言语表达都较高的日子里，患者会免受配偶惩罚反应的影响。这些发现表明，言语和非言语沟通模式中的疼痛表达对配偶的积极和消极反应都很重要。
