Karsdorp Petra A, Geenen Rinie, Kroese Floor M, Vlaeyen Johan W S
Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands; Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
J Pain. 2016 Apr;17(4):499-507. doi: 10.1016/j.jpain.2015.12.014. Epub 2015 Dec 30.
Pain automatically elicits escape-avoidance behavior to avert bodily harm. In patients with chronic pain, long-term escape-avoidance behavior may increase the risk of chronic disability. The aim of the presents study was to examine whether implementation intentions reduce escape-avoidance behavior during painful tasks in healthy individuals. Implementation intentions are "if-then" self-statements associating situational cues with goal-directed behaviors. Seventy healthy participants performed a painful finger pressing task, preceded by either implementation intention instructions with pain or a nonpain cue as a cue for goal-directed behavior, or control instructions. Escape-avoidance behavior was operationalized as task duration and response rate. Inhibitory control was measured using the Stop Signal Task. The pain implementation intentions resulted in the longest task duration (P = .02), and thus less escape-avoidance behavior. Low inhibitory control was associated with shorter task duration (P = .03), and thus more escape-avoidance behavior. The nonpain implementation intentions resulted in the highest response rate, but only when inhibitory control was low (P = .04). Implementation intentions referring to pain or nonpain reduce escape-avoidance behavior on a painful task. It is worthwhile to examine whether individuals in pain and with low inhibitory control benefit from interventions that incorporate implementation intentions.
To our knowledge, this study is the first to show that forming implementation intentions reduces escape-avoidance behavior during pain and fosters nonpain goal pursuit. The use of implementation intentions is indicated to be an intervention that could be of use in patients with pain, particularly when inhibitory control is low.
疼痛会自动引发逃避行为以避免身体伤害。在慢性疼痛患者中，长期的逃避行为可能会增加慢性残疾的风险。本研究的目的是检验实施意图是否能减少健康个体在疼痛任务中的逃避行为。实施意图是将情境线索与目标导向行为联系起来的“如果……那么……”自我陈述。70名健康参与者进行了一项疼痛的手指按压任务，在任务之前，他们要么接受带有疼痛或非疼痛提示的实施意图指导，将其作为目标导向行为的提示，要么接受对照指导。逃避行为通过任务持续时间和反应率来衡量。使用停止信号任务来测量抑制控制能力。疼痛实施意图导致任务持续时间最长（P = 0.02），因此逃避行为较少。低抑制控制能力与较短的任务持续时间相关（P = 0.03），因此逃避行为较多。非疼痛实施意图导致最高的反应率，但仅在抑制控制能力较低时（P = 0.04）。涉及疼痛或非疼痛的实施意图会减少在疼痛任务中的逃避行为。研究疼痛个体和低抑制控制能力个体是否能从包含实施意图的干预措施中获益是值得的。
据我们所知，本研究首次表明形成实施意图可减少疼痛期间的逃避行为，并促进对非疼痛目标的追求。实施意图的运用被认为是一种可用于疼痛患者的干预措施，特别是在抑制控制能力较低时。
