Amaro-Díaz Lidia, Montoro Casandra I, Fischer-Jbali Laura R, Galvez-Sánchez Carmen M
Department of Psychology, University of Jaén, 23071 Jaén, Spain.
Institute of Psychology, University of Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria.
J Clin Med. 2022 Jun 7;11(12):3259. doi: 10.3390/jcm11123259.
Chronic pain is an unpleasant sensory and emotional experience that persists for more than 3 months and is often accompanied by symptoms such as depression, fatigue, sleep disturbances, and cognitive impairment. Emotional dysregulation may also be involved in its etiology. Emotions are known to modulate the experience of pain by influencing cognition and behavior (emotional awareness, emotional expression and experience, and verbalizations). A useful task to explore emotional processing and emotional dysregulation is the emotional Stroop task. Despite the large number of studies using this task, their objectives are diverse; it is necessary to integrate them. The main objective of the present systematic review was to determine the extent of the abnormalities in behavioral performance (including attentional biases) and/or brain alterations in patients with chronic pain during the emotional Stroop task. This systematic review was conducted in accordance with the Cochrane Collaboration guidelines and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The protocol was previously registered in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were extracted from the PubMed, Scopus, and Web of Science databases. Fifteen studies were identified as eligible for systematic review. The studies reported alterations in brain regions related to pain and emotional regulation, as well as attentional bias and higher response time latencies (related to the words' emotional load) in patients with chronic pain. The results confirm the validity of the emotional Stroop task to measure emotions and selective attention. As attentional bias towards negative information is often seen in chronic pain patients, and given the relation between selective attention and greater activation of the brain areas associated with pain and emotional processing, this type of task plays a crucial role in research on emotional and attentional processes among chronic pain patients. Further, attentional bias towards negative information has been associated with higher levels of pain. Taken together, the results suggest the need for cognitive training and an emotional approach to chronic pain therapies, especially targeting attentional biases and negative mood.
慢性疼痛是一种令人不快的感觉和情绪体验，持续超过3个月，常伴有抑郁、疲劳、睡眠障碍和认知障碍等症状。情绪调节异常也可能参与其病因。已知情绪通过影响认知和行为（情绪意识、情绪表达和体验以及言语表达）来调节疼痛体验。探索情绪加工和情绪调节异常的一个有用任务是情绪Stroop任务。尽管有大量研究使用该任务，但其目标各不相同；有必要对它们进行整合。本系统评价的主要目的是确定慢性疼痛患者在情绪Stroop任务期间行为表现（包括注意偏向）异常和/或大脑改变的程度。本系统评价按照Cochrane协作网指南和系统评价与Meta分析的首选报告项目（PRISMA）声明进行。该方案先前已在系统评价前瞻性注册库（PROSPERO）国际数据库中注册。所选文章从PubMed、Scopus和科学网数据库中提取。确定了15项研究符合系统评价的纳入标准。这些研究报告了慢性疼痛患者与疼痛和情绪调节相关的脑区改变，以及注意偏向和更长的反应时间潜伏期（与单词的情绪负荷有关）。结果证实了情绪Stroop任务在测量情绪和选择性注意方面的有效性。由于慢性疼痛患者常出现对负面信息的注意偏向，且鉴于选择性注意与与疼痛和情绪加工相关的脑区更大激活之间的关系，这类任务在慢性疼痛患者的情绪和注意过程研究中起着关键作用。此外，对负面信息的注意偏向与更高水平的疼痛有关。综上所述，结果表明慢性疼痛治疗需要认知训练和情绪干预方法，尤其针对注意偏向和负面情绪。
