Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States.
Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States.
J Psychosom Res. 2020 Sep;136:110172. doi: 10.1016/j.jpsychores.2020.110172. Epub 2020 Jun 24.
Emotional pain (i.e., pain affect in response to psychological experiences such as rejection or loss) may be a component of chronic pain syndromes given high co-occurrence with depression and neurobiological overlaps in pain affect resulting from physical and emotional experiences. In the current set of studies, we examined the relationship between emotional and physical pain using both nomothetic (i.e., group-level) and idiographic (i.e., individual-level) approaches.
Individuals with chronic pain were recruited from the Washington University Pain Center. First, we assessed the relationship between emotional and physical pain at the group level. Then, three individuals from the group-level study completed ecological momentary assessment four times per day for at least four weeks. We assessed relationships between emotional and physical pain using correlations and dynamic structural equation modeling.
Emotional pain severity was significantly positively correlated with physical pain at the group level. However, results from idiographic analyses suggested that one individual did not display a significant correlation between physical and emotional pain, and two individuals displayed correlations larger than expected based on the group-level data. Competing models suggested that emotional and physical pain represented distinct constructs for the individuals studied.
These results suggest that emotional pain may be an important component of chronic pain syndromes. However, idiographic models revealed heterogeneity that may have important implications for treatment. Further research is needed to understand whether idiographic relationships between emotional and physical pain can help identify effective treatment targets for individuals with co-occurring emotional and physical symptoms.
情感疼痛（例如，对拒绝或失落等心理体验的疼痛反应）可能是慢性疼痛综合征的一个组成部分，因为它与抑郁高度共现，并且在身体和情感体验引起的疼痛反应中存在神经生物学重叠。在当前的一系列研究中，我们使用描述性（即群体水平）和个体化（即个体水平）方法来研究情感和身体疼痛之间的关系。
从华盛顿大学疼痛中心招募了患有慢性疼痛的个体。首先，我们在群体水平上评估了情感和身体疼痛之间的关系。然后，来自群体水平研究的三个人每天至少完成四次四次的生态瞬间评估，持续至少四周。我们使用相关性和动态结构方程模型来评估情感和身体疼痛之间的关系。
情感疼痛严重程度在群体水平上与身体疼痛呈显著正相关。然而，个体化分析的结果表明，一个个体的身体和情感疼痛之间没有显著相关性，而两个个体的相关性大于基于群体水平数据的预期。竞争模型表明，情感和身体疼痛代表了所研究个体的不同结构。
这些结果表明，情感疼痛可能是慢性疼痛综合征的一个重要组成部分。然而，个体化模型显示出异质性，这可能对治疗具有重要意义。需要进一步研究以了解情感和身体疼痛之间的个体化关系是否可以帮助识别同时存在情感和身体症状的个体的有效治疗目标。
