Yang J C, Richlin D, Brand L, Wagner J, Clark W C
Psychosom Med. 1985 Sep-Oct;47(5):461-8. doi: 10.1097/00006842-198509000-00006.
Fifty-five low back pain patients and 47 healthy volunteers judged the intensity of calibrated thermal stimuli. The method of constant stimuli yielded a pain threshold, and sensory decision theory (SDT) methods provided two independent indices of perceptual performance: discriminability, P(A), the ability to differentiate among various stimulus intensities; and report criterion, B, the tendency to use a particular response. Compared to healthy volunteers, chronic pain patients were far poorer discriminators [lower P(A)]. In addition, the chronic pain patients were more stoical (higher B) and had higher thresholds for reporting both very faint pain and pain. The poor discriminability in patients could be due to attenuation of afferent neural input. The higher criterion suggests that the thermal stimuli were perceived as being innocuous relative to their clinical pain. Comparison of SDT indices with the threshold measures revealed that the pain threshold was highly correlated to the subject's criterion for reporting pain, B, and unrelated to discriminability, P(A).
55名腰痛患者和47名健康志愿者对校准后的热刺激强度进行了判断。恒定刺激法得出了疼痛阈值，而感觉决策理论（SDT）方法提供了两个独立的感知性能指标：辨别力P(A)，即区分不同刺激强度的能力；以及报告标准B，即使用特定反应的倾向。与健康志愿者相比，慢性疼痛患者的辨别力要差得多（P(A)较低）。此外，慢性疼痛患者更坚忍（B较高），对报告非常轻微的疼痛和疼痛的阈值也更高。患者辨别力差可能是由于传入神经输入的衰减。较高的标准表明，相对于他们的临床疼痛，热刺激被认为是无害的。将SDT指标与阈值测量结果进行比较发现，疼痛阈值与受试者报告疼痛的标准B高度相关，而与辨别力P(A)无关。
