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疼痛主观和客观指标中的个体及性别差异:性别、疼痛恐惧、疼痛灾难化思维与心血管反应性。

Individual and gender differences in subjective and objective indices of pain: gender, fear of pain, pain catastrophizing and cardiovascular reactivity.

作者信息

Etherton Joseph, Lawson Marci, Graham Reiko

机构信息

Department of Psychology, Texas State University, 601 University Dr., San Marcos, TX, 78666, USA,

出版信息

Appl Psychophysiol Biofeedback. 2014 Jun;39(2):89-97. doi: 10.1007/s10484-014-9245-x.

Abstract

According to fear-avoidance models of pain perception, heightened fear of pain may increase disruptive effects of pain; however, the extent to which this affects self-reported pain severity versus physiological indices of pain is not well delineated. The current study examined self-report measures and physiological indices of pain during a cold pressor (CP) task. Individual differences in fear of pain and pain catastrophizing were also assessed via questionnaire. The primary aim of the current study was to examine the extent to which individual differences associated with fear and catastrophizing in response to pain influences subjective and physiological measures of pain. A secondary aim was to examine gender differences associated with response to pain. Average subjective pain ratings were higher for females than males. In contrast, males exhibited higher systolic and diastolic reactivity in response to the CP task relative to females, as well as failure to fully recover to baseline levels. Follow-up correlational analyses revealed that subjective pain ratings were positively associated with fear of pain in both sexes, but were not associated with cardiovascular indices. These results suggest that fear of pain and pain catastrophizing do not influence cardiovascular responses to induced pain. Further research is necessary in order to determine whether these gender differences in blood pressure and heart rate response profiles are due to biological or psychosocial influences. Results support the notion that fear of pain increases subjective pain ratings, but does not influence cardiovascular responses during CP pain-induction.

摘要

根据疼痛感知的恐惧-回避模型,对疼痛的高度恐惧可能会增加疼痛的干扰作用;然而,这种情况对自我报告的疼痛严重程度与疼痛生理指标的影响程度尚未得到明确界定。本研究在冷加压(CP)任务期间检查了疼痛的自我报告测量指标和生理指标。还通过问卷评估了对疼痛的恐惧和疼痛灾难化方面的个体差异。本研究的主要目的是检验与对疼痛的恐惧和灾难化相关的个体差异在多大程度上影响疼痛的主观和生理测量指标。次要目的是检验与对疼痛的反应相关的性别差异。女性的平均主观疼痛评分高于男性。相比之下,男性在CP任务中的收缩压和舒张压反应性相对于女性更高,并且未能完全恢复到基线水平。后续的相关性分析表明,主观疼痛评分在两性中均与对疼痛的恐惧呈正相关,但与心血管指标无关。这些结果表明,对疼痛的恐惧和疼痛灾难化不会影响对诱发疼痛的心血管反应。有必要进行进一步的研究,以确定血压和心率反应模式中的这些性别差异是由生物学影响还是社会心理影响所致。结果支持这样一种观点,即对疼痛的恐惧会增加主观疼痛评分,但在CP疼痛诱发过程中不会影响心血管反应。

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