Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, CA, USA.
Oxford Centre for Children and Young People in Pain (OxCYPP), Nuffield Orthopaedic Centre, Oxford, United Kingdom.
Pain. 2018 Feb;159(2):239-251. doi: 10.1097/j.pain.0000000000001084.
Attention bias for pain-related information is theorised to maintain chronic pain, indicating that changing this bias could improve pain-related outcomes. Modifying attention biases in adolescents, when chronic pain often first emerges, may be particularly beneficial. We report here a randomized, placebo-controlled, parallel-group trial of attention bias modification (ABM) training in adolescents with chronic noncancer pain. Adolescent patients (N = 66) were randomly assigned to complete multiple sessions of dot-probe ABM training (N = 23), placebo training (N = 22), or no training (waitlist; N = 21) across a period of 4 weeks. Patients completed all assessments at a hospital-based pediatric pain clinic and completed all training at home. We examined the relative effects of ABM on attention bias and attention control, as well as pain symptomatology (primary outcome), pain catastrophizing, anxiety and depression symptoms, and functional disability (secondary outcomes) immediately after training and 3 months later. We found no evidence that ABM changed attention bias or attention control in comparison with placebo training or no training. We also found that pain and pain-related outcomes were no different for those undergoing ABM compared with placebo training or no training when tested immediately after training or 3 months later. Overall, we found no evidence to support the efficacy of dot-probe ABM for improving pain-related outcomes in adolescents with chronic pain. This study was registered on the NIHR Clinical Research Network Portfolio in August 2014 (UK Clinical Trials Gateway: CPMS 17251) and funded by a Research Training Fellowship awarded to Lauren Heathcote by Action Medical Research for Children.
注意偏向与疼痛相关的信息被认为可以维持慢性疼痛，这表明改变这种偏向可能会改善与疼痛相关的结果。在慢性疼痛初现时，对青少年进行注意偏向的改变可能尤其有益。我们在此报告了一项针对患有慢性非癌性疼痛的青少年的注意偏向修正（ABM）训练的随机、安慰剂对照、平行组试验。青少年患者（N=66）被随机分配在 4 周内完成多次点探测 ABM 训练（N=23）、安慰剂训练（N=22）或无训练（等待名单；N=21）。患者在一家医院的儿科疼痛诊所完成所有评估，并在家中完成所有训练。我们考察了 ABM 对注意偏向和注意控制的相对影响，以及疼痛症状学（主要结果）、疼痛灾难化、焦虑和抑郁症状以及功能障碍（次要结果），在训练后即刻和 3 个月后进行评估。我们发现，与安慰剂训练或无训练相比，ABM 并没有改变注意偏向或注意控制。我们还发现，在训练后即刻和 3 个月后进行测试时，接受 ABM 的患者的疼痛和与疼痛相关的结果与接受安慰剂训练或无训练的患者没有差异。总的来说，我们没有发现证据支持点探测 ABM 能够改善慢性疼痛青少年的疼痛相关结果。这项研究于 2014 年 8 月在英国国家卫生研究院临床研究网络组合（NIHR Clinical Research Network Portfolio）注册（英国临床试验门户：CPMS 17251），并由 Action Medical Research for Children 授予 Lauren Heathcote 的研究培训奖学金资助。
