Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas.
Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas.
J Pain. 2018 Sep;19(9):962-972. doi: 10.1016/j.jpain.2018.03.007. Epub 2018 Mar 27.
Chronic pain patients show elevated risk behavior on decision-making tasks, as well as increased health risk behaviors (eg, smoking, prescription opioid abuse). Determining pain's effect on underlying cognitive processes that are associated with risk behavior is confounded by comorbidities linked with chronic pain, including depression, anxiety, and substance abuse. Therefore, to understand pain's effect on delay discounting, a behavioral process assessing the extent to which outcomes are devalued as a function of their delay, the present study evaluated the effect of laboratory pain on delay discounting in healthy young adults (N = 85). Using a mixed factorial design, pain (topical capsaicin and warmth) as well as active control (warmth) groups completed a delay discounting task before and during exposure to their respective manipulations. Whereas the pain condition had no effect on delay discounting, participants' pain intensity, unpleasantness, and pain-induced negative valence were associated with less discounting of delayed rewards. However, the effects were very small.
The results suggest that experimental pain may not increase delay discounting, rather sensitivity to pain predicts a very small decrease in discounting of delayed rewards. Although the results are limited to healthy volunteers, this experimental approach allows us to examine the relationship between pain and delay discounting in a controlled manner. Better understanding of pain-related decision-making may lead to improved treatment of health risk behaviors for individuals experiencing pain.
慢性疼痛患者在决策任务中表现出更高的风险行为，以及增加健康风险行为（例如，吸烟、处方类阿片滥用）。确定疼痛对与风险行为相关的潜在认知过程的影响受到与慢性疼痛相关的合并症的混淆，包括抑郁、焦虑和物质滥用。因此，为了了解疼痛对延迟折扣的影响，即评估随着时间的推移结果被低估的程度的行为过程，本研究评估了实验室疼痛对健康年轻成年人（N=85）延迟折扣的影响。使用混合因子设计，疼痛（局部辣椒素和温暖）和主动对照组在暴露于各自的操作之前和期间完成了延迟折扣任务。虽然疼痛条件对延迟折扣没有影响，但参与者的疼痛强度、不适和疼痛引起的负面效价与延迟奖励的折扣减少有关。然而，影响非常小。
结果表明，实验性疼痛可能不会增加延迟折扣，而是对疼痛的敏感性预测延迟奖励折扣的极小减少。尽管结果仅限于健康志愿者，但这种实验方法允许我们以受控的方式检查疼痛与延迟折扣之间的关系。更好地了解与疼痛相关的决策可能会导致对经历疼痛的个体的健康风险行为的治疗得到改善。
