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慢性疼痛中的催眠镇痛:精神病理学和述情障碍的作用。

Hypnotic analgesia in chronic pain: role of psychopathology and alexithymia.

作者信息

Ciaramella Antonella

机构信息

GIFT Institute of Integrative Medicine, Pisa, Italy.

Aplysia A.P.S., Education Program Partner with University of Pisa, MIUR, Florence, Padua, Italy.

出版信息

Am J Clin Hypn. 2023 Apr;65(4):299-313. doi: 10.1080/00029157.2022.2161868. Epub 2023 Feb 7.

DOI:10.1080/00029157.2022.2161868
PMID:36749869
Abstract

Although the belief that hypnotizability is a mental dysfunction has been refuted over time, there is still research today that seeks to explore and clarify this preconception. The results of recent research indicate that, on the contrary, greater psychopathology is more frequent in subjects with low hypnotic susceptibility. Using the Stanford Hypnotic Susceptibility Scale type A (SHSS-A) for hypnotizability, Symptom Checklist-Revised (SCL-90-R) for psychopathology, and the Somatosensory Amplification Scale (SSAS) and Toronto Alexithymia Scale (TAS-20) for psychosomatic dimensions, we found no relationship between baseline psychopathology, alexithymia and hypnotizability in 69 subjects with chronic pain in this retrospective observational study. Psychopathology did not affect the 2-month outcomes of hypnotic suggestions for pain in terms of either pain (assess using Italian Pain Questionnaire), anxiety or depression (assessed through Hospital Anxiety and Depression Scale) scores. Furthermore, i) no relationships were found between hypnotizability and degree of either psychopathology or alexithymia, definitively eliminating any doubts about the belief that hypnosis is a mental dysfunction; ii) only single hypnotic phenomena (SHSS-A) could be linked to some psychopathological dimensions; iii) analgesia suggestions also acted on anxiety and depression; and iv) the use of hypnotic suggestions for analgesia revealed a close relationship between improvements in sensorial and evaluative dimensions of pain and mitigation of anxiety. Hypnosis thereby seems to be a powerful tool in psychosomatic medicine whose effects on mind and body are inextricably linked.

摘要

尽管随着时间的推移,认为催眠易感性是一种心理功能障碍的观点已被驳斥,但如今仍有研究试图探索和澄清这一先入之见。最近的研究结果表明,恰恰相反,在催眠易感性较低的受试者中,更多见的是更严重的精神病理学表现。在这项回顾性观察研究中,我们对69名慢性疼痛患者使用斯坦福A型催眠易感性量表(SHSS-A)评估催眠易感性,使用症状自评量表修订版(SCL-90-R)评估精神病理学,使用体感放大量表(SSAS)和多伦多述情障碍量表(TAS-20)评估心身维度,发现基线精神病理学、述情障碍与催眠易感性之间没有关联。就疼痛(使用意大利疼痛问卷评估)、焦虑或抑郁(通过医院焦虑抑郁量表评估)得分而言,精神病理学并未影响催眠暗示对疼痛的2个月疗效。此外,i)未发现催眠易感性与精神病理学或述情障碍程度之间存在关联,从而彻底消除了对催眠是一种心理功能障碍这一观点的任何疑虑;ii)只有单一的催眠现象(SHSS-A)可能与某些精神病理学维度相关;iii)镇痛暗示对焦虑和抑郁也有作用;iv)使用催眠暗示进行镇痛显示,疼痛的感觉和评估维度的改善与焦虑减轻之间存在密切关系。因此,催眠似乎是心身医学中的一种强大工具,其对身心的影响是紧密相连的。

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