Yu WenJun, Guan Fang, Fu Li, Long Cheng, Yang Li
School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, People's Republic of China,
College of Education, JingGangShan University, Ji'an, People's Republic of China.
J Pain Res. 2018 Aug 3;11:1469-1477. doi: 10.2147/JPR.S168516. eCollection 2018.
Dysmenorrhea (DM), which involves both acute and chronic pain, is associated with abnormalities in pain modulation. Previous studies have shown that social pain relies on some of the same neural regions that process physical pain, highlighting a possible physical-social pain overlap. However, evidence suggesting that social pain modulates the sensitivity to physical pain remains controversial. The present study aimed to assess the effects of social pain manipulation on sensitivity to physical pain in DM sufferers and healthy female controls (HC).
Fifty-nine otherwise healthy patients with DM and 55 HC matched for age, education, calendar age, and gynecological age were randomly assigned to inclusion or exclusion conditions of Cyberball, a virtual ball tossing game used to induce social pain (social exclusion). Pain threshold and pain tolerance in response to nociceptive pressure and cold stimuli were assessed before and after the study condition.
In response to cold stimulation, pain threshold and tolerance significantly reduced in DM compared to HC participants in the inclusion condition, indicating increased pain sensitivity in DM group. However, exclusion increased the pain threshold and tolerance compared to inclusion in DM but decreased pain threshold and tolerance in HC. Neither inclusion nor exclusion altered pressure pain sensitivity in DM, but, after social exclusion, DM participants were more fearful of being evaluated unfavorably. No significant differences were observed in self-esteem scores between DM and HC after both inclusion and exclusion.
We observed altered pain sensation in DM participants in response to social pain manipulation, suggesting that DM not only impacts menstruation but also modulates the perception of pain more generally, especially its affective processes. The present study suggests that the effect of social pain on pain sensation and certain psychometric properties depends on previous pain experience, implicating a reciprocal influence of social and physical pain processes.
痛经（DM）涉及急性和慢性疼痛，与疼痛调节异常有关。先前的研究表明，社会疼痛依赖于一些处理身体疼痛的相同神经区域，突出了身体 - 社会疼痛可能存在的重叠。然而，关于社会疼痛调节身体疼痛敏感性的证据仍存在争议。本研究旨在评估社会疼痛操纵对痛经患者和健康女性对照（HC）身体疼痛敏感性的影响。
59名其他方面健康的痛经患者和55名年龄、教育程度、日历年龄和妇科年龄相匹配的健康对照者被随机分配到“Cyberball”（一种用于诱发社会疼痛（社会排斥）的虚拟抛球游戏）的纳入或排除条件组。在研究条件前后，评估对伤害性压力和冷刺激的疼痛阈值和疼痛耐受性。
在纳入条件下，与健康对照参与者相比，痛经患者对冷刺激的疼痛阈值和耐受性显著降低，表明痛经组疼痛敏感性增加。然而，与纳入相比，排除使痛经患者的疼痛阈值和耐受性增加，但使健康对照者的疼痛阈值和耐受性降低。纳入和排除均未改变痛经患者的压力疼痛敏感性，但在社会排斥后，痛经患者更害怕受到不利评价。纳入和排除后，痛经患者和健康对照者的自尊得分均未观察到显著差异。
我们观察到痛经参与者在社会疼痛操纵后疼痛感觉发生改变，这表明痛经不仅影响月经，还更普遍地调节疼痛感知，尤其是其情感过程。本研究表明，社会疼痛对疼痛感觉和某些心理测量特性的影响取决于先前的疼痛经历，这意味着社会和身体疼痛过程存在相互影响。
