Braw Yoram, Goor-Aryeh Itay, Ratmansky Motti
Department of Psychology, Ariel University, Ariel, Israel.
Pain Clinic, Sheba Tel-HaShomer Medical Center, Ramat Gan, Israel.
Pain Pract. 2025 Sep;25(7):e70074. doi: 10.1111/papr.70074.
The Numerical Pain Rating Scale (NPRS) is routinely used to assess pain severity. A recently developed NPRS integrated the pain scale with an eye tracker (NPRS). As part of this study, we explored the NPRS's utility to detect feigned pain, an ongoing challenge facing clinicians. To achieve this aim, chronic pain outpatients were randomly assigned to a simulation (i.e., requested to exaggerate their pain; n = 34) or a control condition (i.e., requested to genuinely report their pain severity; n = 35). They then rated their pain using the NPRS. Eye movement analyses indicated that simulators spent more time gazing at the higher NPRS pain ratings before providing their pain ratings and less time at the leftward ("No pain") anchor afterward. The discrimination capacities of these measures, however, were poor. In contrast, pain ratings using the NPRS showed excellent discriminative capacity, with a pain rating of 10 associated with 94.3% specificity and 26.5% sensitivity. Overall, the study's findings further indicate the feasibility of incorporating an eye tracker to evaluate the severity of pain. Though the findings at present do not support the utility of NPRS-based eye movement measures as validity indicators, pain ratings showed promise as a simple screen of feigned pain. The preliminary nature of the findings, however, calls for further research. Such research may aid in further developing effective indicators of feigned pain and hopefully clarify cognitive processes (e.g., experienced cognitive load) involved in pain deception. PERSPECTIVE: The NPRS enables pain ratings by patients with severe motor and speech impairments. While eye movements were not adequate in detecting feigned pain, participants' pain ratings showed initial promise. As this is a preliminary study, further research is recommended.
数字疼痛评分量表（NPRS）通常用于评估疼痛严重程度。最近开发的一种NPRS将疼痛量表与眼动仪相结合（NPRS）。作为本研究的一部分，我们探讨了NPRS在检测伪装疼痛方面的效用，这是临床医生面临的一个持续挑战。为实现这一目标，慢性疼痛门诊患者被随机分配到模拟组（即要求夸大疼痛；n = 34）或对照组（即要求如实报告疼痛严重程度；n = 35）。然后他们使用NPRS对自己的疼痛进行评分。眼动分析表明，模拟者在给出疼痛评分之前，花更多时间注视较高的NPRS疼痛评分，之后花较少时间注视向左的（“无疼痛”）锚点。然而，这些测量方法的辨别能力较差。相比之下，使用NPRS进行的疼痛评分显示出出色的辨别能力，疼痛评分为10时，特异性为94.3%，敏感性为26.5%。总体而言，该研究结果进一步表明了结合眼动仪评估疼痛严重程度的可行性。尽管目前的研究结果不支持将基于NPRS的眼动测量作为有效性指标，但疼痛评分有望作为伪装疼痛的一种简单筛查方法。然而，研究结果的初步性质需要进一步研究。此类研究可能有助于进一步开发伪装疼痛的有效指标，并有望阐明疼痛欺骗中涉及的认知过程（如经历的认知负荷）。观点：NPRS使严重运动和言语障碍患者能够进行疼痛评分。虽然眼动在检测伪装疼痛方面并不充分，但参与者的疼痛评分显示出初步的前景。由于这是一项初步研究，建议进行进一步研究。
