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简短正念干预对实验性热痛对健康个体认知干扰的影响。

Effects of Brief Mindfulness Interventions on the Interference Induced by Experimental Heat Pain on Cognition in Healthy Individuals.

作者信息

Gill Louis-Nascan, Tabry Vanessa, Taylor Véronique, Lussier Maxime, Martinu Kristina, Bherer Louis, Roy Mathieu, Rainville Pierre

机构信息

Department of Psychology, Université de Montréal, Montreal, QC, Canada.

Department of Psychology, McGill University, Montreal, QC, Canada.

出版信息

Front Pain Res (Lausanne). 2021 Jun 2;2:673027. doi: 10.3389/fpain.2021.673027. eCollection 2021.

Abstract

Pain captures attention and interferes with competing tasks demanding cognitive effort. Brief mindfulness interventions involving both conceptual learning and meditation exercises have been shown to improve attention and reduce pain sensitivity, and could potentially reduce pain interference. This study assesses the effect of a 5-day mindfulness intervention (20 min/day) on the interference produced by thermal pain on working memory performance using a 2-back task. Healthy participants were randomized into three groups exposed to mindfulness meditation training ( = 15), an active educational control intervention comprising only conceptual information on mindfulness ( = 15), or no intervention ( = 15). The two active interventions were administered in a dual-blind fashion and outcomes were assessed by research personnel blind to this allocation. Evaluation sessions were conducted before and after the interventions to assess the effect of pain on 2-back performance (pain interference). Importantly, both pain stimuli and the 2-back task were calibrated individually and in each session before assessing pain interference, thereby controlling for possible changes in baseline pain sensitivity and cognitive performance. Secondary outcomes included heat pain sensitivity, cold pain tolerance, cognitive inhibition, cognitive flexibility, and divided attention. Manipulation checks confirmed that heat pain interferes with the performance of the working-memory task. Compared to the no-intervention control group, pain interference was significantly reduced following the conceptual intervention but not the meditation intervention, although a corollary analysis suggests the effect might be due to regression toward the mean caused by baseline imbalance in pain interference. Secondary outcomes also suggested an increase in pain tolerance in the conceptual learning group only. A short mindfulness meditation intervention was insufficient to reduce pain interference but conceptual learning about mindfulness produced some unexpected benefits. Although the generalization of experimental findings to clinical pain conditions may be premature, these results highlight the importance of distinguishing the contribution of mindfulness education and meditation training in future studies. Understanding the effects of mindfulness training on pain regulation and management must take into consideration the multiple factors underlying this complex intervention.

摘要

疼痛会吸引注意力,并干扰需要认知努力的其他竞争任务。简短的正念干预,包括概念学习和冥想练习,已被证明可以提高注意力并降低疼痛敏感性,还可能减少疼痛干扰。本研究使用2-回溯任务评估了为期5天的正念干预(每天20分钟)对热痛对工作记忆表现产生的干扰的影响。健康参与者被随机分为三组,分别接受正念冥想训练(n = 15)、仅包含正念概念信息的积极教育对照干预(n = 15)或不接受干预(n = 15)。两种积极干预均采用双盲方式进行,结果由对该分配不知情的研究人员评估。在干预前后进行评估,以评估疼痛对2-回溯表现(疼痛干扰)的影响。重要的是,在评估疼痛干扰之前,在每次会话中分别对疼痛刺激和2-回溯任务进行校准,从而控制基线疼痛敏感性和认知表现的可能变化。次要结果包括热痛敏感性、冷痛耐受性、认知抑制、认知灵活性和分散注意力。操作检查证实热痛会干扰工作记忆任务的表现。与无干预对照组相比,概念干预后疼痛干扰显著降低,但冥想干预后未降低,尽管一项相关分析表明,这种效果可能是由于疼痛干扰基线不平衡导致的均值回归。次要结果还表明,仅概念学习组的疼痛耐受性有所增加。简短的正念冥想干预不足以减少疼痛干扰,但关于正念的概念学习产生了一些意想不到的益处。尽管将实验结果推广到临床疼痛情况可能为时过早,但这些结果凸显了在未来研究中区分正念教育和冥想训练贡献的重要性。理解正念训练对疼痛调节和管理的影响必须考虑到这种复杂干预背后的多种因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e0b/8915756/297f266f43b2/fpain-02-673027-g0001.jpg

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