Jackson Todd, Wang Yang, Fan Huiyong
Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing, China; Faculty of Psychological Science, Southwest University, Chongqing, China.
Faculty of Psychological Science, Southwest University, Chongqing, China.
J Pain. 2014 Jun;15(6):586-601. doi: 10.1016/j.jpain.2014.01.499. Epub 2014 Feb 11.
In this research, meta-analyses were performed to evaluate associations between primary appraisals of pain as a source of threat and/or challenge and responses to 1) noxious laboratory stimuli and 2) chronic noncancer pain. Twenty-two laboratory pain studies comprising 2,031 participants and 59 chronic pain studies based on 9,135 patients were identified for analysis. For laboratory pain, elevated threat appraisals were linked to overall increases in reported pain, reduced pain tolerance, and high levels of passive coping. Method of measuring appraisal as well as type and duration of noxious stimulation moderated some of these associations. Challenge appraisals were related to more pain tolerance and less passive coping but not pain intensity. For chronic pain studies, threat appraisals had positive overall correlations with pain intensity, impairment, affective distress, and passive coping but were negatively related to active coping. The pattern of associations between challenge appraisals and outcomes was largely complementary. Appraisal scale used and gender were consistent moderators of appraisal-outcome relations in chronic pain samples. In sum, appraisals of pain as a source of potential damage or opportunity have robust associations with responses to acute laboratory pain and ongoing chronic pain.
Meta-analyses evaluated associations between primary appraisals and responses to laboratory pain and chronic pain. Significant effect sizes for most outcomes suggest that appraisals of pain as a source of threat and challenge have important implications for functioning in response to pain.
在本研究中，进行了荟萃分析，以评估将疼痛初步评估为威胁和/或挑战来源与对以下两种情况的反应之间的关联：1）有害的实验室刺激；2）慢性非癌性疼痛。确定了22项包含2031名参与者的实验室疼痛研究和59项基于9135名患者的慢性疼痛研究进行分析。对于实验室疼痛，较高的威胁评估与报告疼痛的总体增加、疼痛耐受性降低以及高水平的消极应对相关。评估测量方法以及有害刺激的类型和持续时间调节了其中一些关联。挑战评估与更高的疼痛耐受性和更少的消极应对相关，但与疼痛强度无关。对于慢性疼痛研究，威胁评估与疼痛强度、功能损害、情感痛苦和消极应对呈正相关，但与积极应对呈负相关。挑战评估与结果之间的关联模式在很大程度上是互补的。所使用的评估量表和性别是慢性疼痛样本中评估与结果关系的一致调节因素。总之，将疼痛评估为潜在损害或机会的来源与对急性实验室疼痛和持续慢性疼痛的反应有密切关联。
荟萃分析评估了初步评估与对实验室疼痛和慢性疼痛的反应之间的关联。大多数结果的显著效应大小表明，将疼痛评估为威胁和挑战的来源对疼痛反应功能有重要影响。
