Pain and Psychotherapy Research Lab, University of Koblenz-, Landau, Germany.
Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany.
J Psychosom Res. 2022 Jun;157:110807. doi: 10.1016/j.jpsychores.2022.110807. Epub 2022 Apr 1.
Expectations of painful sensations constitute a core feature of chronic pain. An important clinical question is whether such expectations are revised when disconfirming experiences are made (e.g., less pain than expected). This study examined how people adjust their pain expectations when the experience of decreasing pain is expected vs. unexpected.
In a novel randomized between-subjects design, a subclinical sample of people who frequently experience pain was provided with painful thermal stimulations. Unbeknownst to participants, the temperature applied was decreased from trial to trial. Based on the experimental instructions provided, this experience of decreasing pain was expected in one condition (expectation-confirmation; n = 34), whereas it was unexpected in another (expectation-disconfirmation; n = 39).
Perceived pain intensity was lower in the expectation-confirmation condition than in the expectation-disconfirmation condition (p = .014, η = 0.083). The expectation-confirmation condition also showed a greater adjustment of their pain expectations than the expectation-disconfirmation condition (p = .046, η = 0.047). Across groups, large expectation violations (i.e., less pain than expected) were associated with increases in pain tolerance and the ability to cope with pain at a one-week follow-up.
In terms of assimilation, perceived pain intensity was shaped in the direction of pain expectations. The greater adjustment of expectations in the expectation-confirming condition is consistent with a confirmation bias in pain perception. Though participants who experienced large discrepancies between expected and experienced pain were hesitant to adjust their pain expectations immediately, expectation violations increased their ability to cope with pain one week later, suggesting some beneficial longer-term effects of expectation violations.
对疼痛感觉的预期是慢性疼痛的一个核心特征。一个重要的临床问题是，当出现与预期不符的体验时（例如，疼痛程度低于预期），这种预期是否会被修正。本研究探讨了当体验到疼痛减轻时，人们如何调整他们的疼痛预期，即这种体验是预期的还是意外的。
在一项新颖的随机分组实验中，一个经常经历疼痛的亚临床样本被给予了热痛刺激。在参与者不知情的情况下，施加的温度在每次试验中都有所降低。根据提供的实验指令，在一种条件下（预期确认；n=34），这种疼痛减轻的体验是预期的，而在另一种条件下（预期否定；n=39），这种体验是意外的。
在预期确认条件下，感知到的疼痛强度低于预期否定条件（p=0.014，η=0.083）。与预期否定条件相比，预期确认条件也表现出更大的疼痛预期调整（p=0.046，η=0.047）。在两个组中，较大的预期偏差（即疼痛程度低于预期）与疼痛耐受力的增加和一周后应对疼痛的能力的增加相关。
在同化方面，感知到的疼痛强度朝着疼痛预期的方向塑造。在预期确认条件下，预期的更大调整与疼痛感知中的确认偏差一致。尽管经历了预期与实际疼痛之间较大差异的参与者立即调整疼痛预期犹豫不决，但预期偏差增加了他们一周后应对疼痛的能力，这表明预期偏差有一些有益的长期影响。
