Kalingel-Levi Merry, Schreuer Naomi, Granovsky Yelena, Bar-Shalita Tami, Weissman-Fogel Irit, Hoffman Tseela, Gal Eynat
Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Laboratory of Clinical Neurophysiology, Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
Front Psychol. 2022 Jun 14;13:911756. doi: 10.3389/fpsyg.2022.911756. eCollection 2022.
Pain sensation in autism spectrum disorder (ASD) has been a growing research field in the last two decades. Existing pain research has focused on pain sensitivity, suggesting either hyposensitivity or hypersensitivity to pain in individuals with ASD. However, research about other aspects of pain experience is scarce. Moreover, most pain-related research in ASD focused on quantitative measures, such as neuroimaging or parental reports. Instead, this paper aimed to illuminate the various aspects of pain experience as perceived by adults with ASD. Its descriptive qualitative research design incorporated semi-structured interviews and deductive thematic analysis. This phenomenological approach captured the subjective pain experience through the lens of people with ASD. Four primary themes emerged from the data: (a) physical pain experience, including the sequence of pain sensitivity, pain awareness, pain-related emotional aspects, and pain communication; (b) direct and indirect coping strategies; (c) function and participation outcomes; and (d) suggestions for Healthcare Providers. The findings echo the crucial role of pain awareness and communication in the pain experience of people with ASD. These two factors have been reported as profoundly influencing coping strategies, function, and participation. The results emphasize the need to expand the exploration of pain in this population, calling for greater understanding, and listening to this population's unique pain profiles and experiences to promote better-suited evaluation, diagnosis, and intervention in pain conditions.
在过去二十年中，自闭症谱系障碍（ASD）中的疼痛感知一直是一个不断发展的研究领域。现有的疼痛研究主要集中在疼痛敏感性上，表明ASD患者对疼痛要么低敏要么高敏。然而，关于疼痛体验其他方面的研究却很匮乏。此外，大多数关于ASD疼痛的研究都集中在定量测量上，如神经影像学或家长报告。相反，本文旨在阐明成年ASD患者所感知的疼痛体验的各个方面。其描述性定性研究设计采用了半结构化访谈和演绎主题分析。这种现象学方法通过ASD患者的视角捕捉主观疼痛体验。数据中出现了四个主要主题：（a）身体疼痛体验，包括疼痛敏感性顺序、疼痛意识、与疼痛相关的情感方面以及疼痛交流；（b）直接和间接应对策略；（c）功能和参与结果；（d）对医疗服务提供者的建议。研究结果呼应了疼痛意识和交流在ASD患者疼痛体验中的关键作用。据报道，这两个因素对应对策略、功能和参与有深远影响。结果强调有必要扩大对该人群疼痛的探索，呼吁增进理解，并倾听该人群独特的疼痛特征和经历，以促进对疼痛状况进行更合适的评估、诊断和干预。
