From the Department of Psychology (Michalska), University of California Riverside, Riverside, California; Department of Psychology (Feldman, Palacios-Barrios), University of Pittsburgh, Pittsburgh, Pennsylvania; The National Institute of Mental Health, Emotion and Development Branch (Abend, Gold, Leibenluft, Towbin, Pine); National Center for Complementary and Integrative Health (Dildine, Atlas), Bethesda, Maryland; Department of Clinical Neuroscience (Dildine), Karolinska Institutet, Stockholm, Sweden; and National Institute on Drug Abuse (Atlas), Baltimore, Maryland.
Psychosom Med. 2018 Nov/Dec;80(9):853-860. doi: 10.1097/PSY.0000000000000608.
Naturalistic studies suggest that expectation of adverse experiences such as pain exerts particularly strong effects on anxious youth. In healthy adults, expectation influences the experience of pain. The current study uses experimental methods to compare the effects of expectation on pain among adults, healthy youth, and youth with an anxiety disorder.
Twenty-three healthy adults, 20 healthy youth, and 20 youth with an anxiety disorder underwent procedures in which auditory cues were paired with noxious thermal stimulation. Through instructed conditioning, one cue predicted low-pain stimulation and the other predicted high-pain stimulation. At test, each cue was additionally followed by a single temperature calibrated to elicit medium pain ratings. We compared cue-based expectancy effects on pain across the three groups, based on cue effects on pain elicited on medium heat trials.
Across all groups, as expected, participants reported greater pain with increasing heat intensity (β = 2.29, t(41) = 29.94, p < .001). Across all groups, the critical medium temperature trials were rated as more painful in the high- relative to low-expectancy condition (β = 1.72, t(41) = 10.48, p < .001). However, no evidence of between-group differences or continuous associations with age or anxiety was observed.
All participants showed strong effects of expectancy on pain. No influences of development or anxiety arose. Complex factors may influence associations among anxiety, development, and pain reports in naturalistic studies. Such factors may be identified using experiments that employ more complex, yet controlled manipulations of expectancy or assess neural correlates of expectancy.
自然主义研究表明，对疼痛等不良体验的预期会对焦虑的年轻人产生特别强烈的影响。在健康成年人中，预期会影响疼痛体验。本研究使用实验方法比较了成年人、健康青年和焦虑障碍青年中预期对疼痛的影响。
23 名健康成年人、20 名健康青年和 20 名焦虑障碍青年接受了程序，其中听觉提示与有害的热刺激配对。通过指令性条件作用，一个提示预示着低痛刺激，另一个提示预示着高痛刺激。在测试中，每个提示后面都跟有一个单独的温度，以引起中等疼痛评分。我们比较了三组基于线索的预期对疼痛的影响，基于线索对中等热度试验引起的疼痛的影响。
在所有组中，正如预期的那样，随着热量强度的增加，参与者报告的疼痛程度更大（β=2.29，t(41)=29.94，p<.001）。在所有组中，关键的中等温度试验在高预期条件下比低预期条件下被评定为更疼痛（β=1.72，t(41)=10.48，p<.001）。然而，没有观察到组间差异或与年龄或焦虑的连续关联。
所有参与者都表现出预期对疼痛的强烈影响。没有发现发展或焦虑的影响。复杂的因素可能会影响自然主义研究中焦虑、发展和疼痛报告之间的关联。可以通过使用更复杂但控制预期的实验，或者评估预期的神经相关性，来识别这些因素。
