Schmidt A J, Arntz A
Department of Medical Psychology, University of Limburg, Maastricht, The Netherlands.
Soc Sci Med. 1987;25(10):1095-104. doi: 10.1016/0277-9536(87)90350-9.
Some of the main psychological research topics concerning chronic low back pain (CLBP) are critically discussed. These topics include: 1. research aimed at describing a specific low back pain personality profile, 2. research into the predictability of therapy results on the basis of psychological assessment, and 3. outcome research of psychologically-oriented treatment for CLBP. It is concluded that these topics provide little insight into the role of psychological factors in the development and maintenance of CLBP. Based on the few empirical studies available, some new and promising directions for future research are proposed, aimed at gaining a better insight into the CLBP syndrome itself. Discussed are: 1. Risk factors in the transition from acute to chronic LBP, 2. the deviant sensitivity to acute, experimental pain stimuli of CLBP patients, 3. the relationship between CLBP behavior and psychophysiologic variables, 4. determinants of CLBP behavior, with special attention to endurance, 5. the deviant processing of proprioceptive stimuli, and 6. the implementation for chronic pain of the unpredictability and uncontrollability paradigms. The emphasis in the presentation of these new topics is more on raising questions than on answering them.
本文对一些关于慢性下腰痛（CLBP）的主要心理学研究课题进行了批判性讨论。这些课题包括：1. 旨在描述特定下腰痛人格特征的研究；2. 基于心理评估的治疗效果可预测性研究；3. 针对CLBP的心理导向治疗的结果研究。结论是，这些课题对心理因素在CLBP发生和维持中的作用洞察甚微。基于现有的少量实证研究，提出了一些新的、有前景的未来研究方向，旨在更好地洞察CLBP综合征本身。讨论的内容有：1. 从急性下腰痛转变为慢性下腰痛的风险因素；2. CLBP患者对急性实验性疼痛刺激的异常敏感性；3. CLBP行为与心理生理变量之间的关系；4. CLBP行为的决定因素，特别关注耐力；5. 本体感觉刺激的异常处理；6. 不可预测性和不可控性范式在慢性疼痛中的应用。在介绍这些新课题时，重点更多地是提出问题而非回答问题。
