Garland Eric L
Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, United States.
College of Social Work, University of Utah, Salt Lake City, UT, United States.
Pain. 2020 Dec;161(12):2659-2666. doi: 10.1097/j.pain.0000000000001988.
Clinicians and scientists have begun to recognize that chronic pain and its treatment with opioid analgesics may occasion —a blunting of physiological and positive emotional responses to rewarding objects and events in the social environment. Conversely, pain relief can be rewarding [83,84]. Yet, this relation is not unidirectional; experimental manipulations and clinical observational studies demonstrate the analgesic effects of positive affect and reward [32,86]. Although positive emotions and rewarding experiences can produce analgesia, how might they be intentionally cultivated for their therapeutic value? To answer this research question, this topical review proposes a mechanistic model (Figure 1) for optimizing psychosocial interventions by leveraging positive affective/reward-related mechanisms as means of addressing chronic pain and opioid misuse.
临床医生和科学家们已经开始认识到，慢性疼痛及其使用阿片类镇痛药进行的治疗，可能会导致——对社交环境中令人愉悦的事物和事件的生理和积极情绪反应变得迟钝。相反，疼痛缓解可能是有益的[83,84]。然而，这种关系并非单向的；实验操作和临床观察研究表明，积极情绪和奖赏具有镇痛作用[32,86]。尽管积极情绪和奖赏体验可以产生镇痛效果，但如何有意培养它们以发挥其治疗价值呢？为了回答这个研究问题，本专题综述提出了一个机制模型（图1），通过利用与积极情感/奖赏相关的机制作为解决慢性疼痛和阿片类药物滥用问题的手段，来优化心理社会干预措施。
