School of Psychology, University of Sydney, Sydney, NSW, Australia.
Pain Management Research Institute (PMRI), Royal North Shore Hospital, St Leonards, NSW, Australia.
Pain. 2021 Jul 1;162(7):2110-2119. doi: 10.1097/j.pain.0000000000002212.
Psychological models of chronic pain (CP) highlight cognitive-processing biases (ie, attentional biases, interpretation biases, and attentional control) as pivotal processes that uniquely and synergistically impact the development and maintenance of CP. Very few studies explore multiple cognitive biases, and no studies have examined these 3 processes together in a CP sample. Furthermore, there is a lack of research investigating the relationship between these cognitive processes and pain-relevant variables (eg, pain intensity and pain catastrophising). The current study aimed to (1) compare attentional biases, interpretation biases, and attentional control in people with and without CP, (2) explore their interrelationships, and (3) explore their association with pain-related variables. Seventy-four participants with CP and 66 without pain volunteered. Participants completed a visual scanning task with eye tracking, a recognition task, and a flanker task. Traditional and Bayesian analysis indicated no effect of pain status on cognitive-processing biases. All participants, regardless of pain status, demonstrated attentional biases towards pain on some indices of early and late attention, but not interpretation bias or attentional control. There was weak evidence of associations between attentional biases, interpretation biases, and attentional control. Pain intensity was significantly correlated with interpretation biases, and follow-up analyses revealed people with high pain intensity demonstrated an interpretation bias towards pain significantly more than those with low pain intensity. Findings suggest that attentional biases towards pain are ubiquitous, but for people with moderate-to-severe pain, interpretation biases may have a role worthy of further research.
慢性疼痛（CP）的心理模型强调认知加工偏差（即注意偏差、解释偏差和注意控制）是影响 CP 发展和维持的关键过程。很少有研究探索多种认知偏差，也没有研究在 CP 样本中同时研究这 3 个过程。此外，缺乏研究调查这些认知过程与疼痛相关变量（例如疼痛强度和疼痛灾难化）之间的关系。本研究旨在：（1）比较 CP 患者和无疼痛患者的注意偏差、解释偏差和注意控制；（2）探讨它们之间的相互关系；（3）探讨它们与疼痛相关变量的关系。74 名 CP 患者和 66 名无疼痛志愿者参加了研究。参与者完成了视觉扫描任务（带有眼动追踪）、识别任务和侧抑制任务。传统和贝叶斯分析表明，疼痛状态对认知加工偏差没有影响。所有参与者，无论疼痛状态如何，在早期和晚期注意的某些指标上都表现出对疼痛的注意偏向，但没有表现出解释偏差或注意控制。注意偏向、解释偏差和注意控制之间存在微弱的关联证据。疼痛强度与解释偏差显著相关，后续分析表明，疼痛强度高的人表现出的疼痛解释偏向明显高于疼痛强度低的人。研究结果表明，对疼痛的注意偏向普遍存在，但对于中重度疼痛患者，解释偏差可能具有进一步研究的价值。
