Sharpe Louise, Haggman Sonia, Nicholas Michael, Dear Blake F, Refshauge Kathryn
School of Psychology, The University of Sydney, NSW, Australia Pain Management Research Institute, The University of Sydney, NSW, Australia School of Physiotherapy, The University of Sydney, NSW, Australia Department of Psychology, Macquarie University, NSW, Australia.
Pain. 2014 Jan;155(1):45-52. doi: 10.1016/j.pain.2013.09.004. Epub 2013 Sep 9.
This prospective study of acute and sub-acute low back pain (LBP) patients was conducted to assess whether attentional biases predicted chronic pain status 3 and 6 months later. The attentional biases of 100 LBP patients were assessed within 3 months of developing pain and 6 months later. Participants also completed measures associated with outcome at 3 assessment points: baseline, 3 and 6 months later. Current pain status was assessed at follow-ups. Patients were classified as those that met standard criteria for chronic pain or those who did not (i.e., the comparison group). At baseline, participants demonstrated a bias toward sensory pain words. However, biases toward sensory pain words did not differentiate those who subsequently developed chronic pain and those who did not at either follow-up. The same bias was observed 6 months later, but again it failed to distinguish between the chronic pain and comparison groups. However, subjects who developed chronic pain at both 3 (n=22) and 6 (n=21) months demonstrated biases away from affective pain words at baseline but not 6 months later, in comparison to other participants. These results remained significant in multivariate analyses. These findings are consistent with patterns observed in the previous research, and suggest that avoidance of emotionally laden pain-related stimuli (i.e., affective pain words) is associated with negative outcomes for LBP patients in the acute and sub-acute phase. This research suggests that attentional biases in relation to pain-related stimuli are important for the development of chronic pain, but are more complex than initially thought.
这项针对急性和亚急性下背痛（LBP）患者的前瞻性研究旨在评估注意力偏向是否能预测3个月和6个月后的慢性疼痛状态。在100名LBP患者出现疼痛后的3个月内及6个月后评估其注意力偏向。参与者还在3个评估点完成了与结果相关的测量：基线、3个月后和6个月后。在随访时评估当前疼痛状态。患者被分为符合慢性疼痛标准的患者和不符合标准的患者（即对照组）。在基线时，参与者对感觉性疼痛词汇表现出偏向。然而，对感觉性疼痛词汇的偏向在两次随访中均未能区分随后发展为慢性疼痛的患者和未发展为慢性疼痛的患者。6个月后观察到相同的偏向，但它同样未能区分慢性疼痛组和对照组。然而，与其他参与者相比，在3个月（n = 22）和6个月（n = 21）时均发展为慢性疼痛的受试者在基线时对情感性疼痛词汇表现出偏向，但在6个月后则没有。这些结果在多变量分析中仍然显著。这些发现与先前研究中观察到的模式一致，并表明避免与疼痛相关的情感负荷刺激（即情感性疼痛词汇）与急性和亚急性阶段LBP患者的负面结果相关。这项研究表明与疼痛相关刺激有关的注意力偏向对慢性疼痛的发展很重要，但比最初认为的更为复杂。
