McCracken L M, Gross R T, Sorg P J, Edmands T A
Department of Psychology, School of Medicine, West Virginia University, Morgantown 26506.
Behav Res Ther. 1993 Sep;31(7):647-52. doi: 10.1016/0005-7967(93)90117-d.
This study investigated predictions of pain intensity, reports of pain and anxiety, frequency of pain-related anxiety symptoms, and range of motion, in 43 patients exposed to pain during a physical examination. All patients had primary complaints of low back pain. The pain stimuli used for this study included back and/or leg pain produced by repeatedly raising the extended leg of the patient to the point of pain tolerance. Generally, findings demonstrated that (a) predictions of pain were a function of discrepancies between previous predictions and experiences of pain, (b) patients reporting greater pain-related anxiety showed a tendency to overpredict new pain events, but corrected their predictions readily, (c) patients reporting less pain-related anxiety displayed a persistent tendency to underpredict pain, and (d) higher predictions of pain, independent of pain reports, related to less range of motion during a procedure that involved painful movement. Discussion focuses on differences between these results and those of previous studies and the implications of inaccurate prediction for continued pain and disability.
本研究调查了43名在体格检查中经历疼痛的患者的疼痛强度预测、疼痛和焦虑报告、疼痛相关焦虑症状的频率以及活动范围。所有患者的主要主诉均为腰痛。本研究使用的疼痛刺激包括通过反复将患者伸直的腿抬高到疼痛耐受点而产生的背部和/或腿部疼痛。一般来说，研究结果表明：（a）疼痛预测是先前预测与疼痛体验之间差异的函数；（b）报告有更多疼痛相关焦虑的患者倾向于过度预测新的疼痛事件，但能迅速纠正他们的预测；（c）报告有较少疼痛相关焦虑的患者持续表现出低估疼痛的倾向；（d）在涉及疼痛动作的过程中，与疼痛报告无关，较高的疼痛预测与较小的活动范围相关。讨论集中在这些结果与先前研究结果的差异，以及不准确预测对持续疼痛和残疾的影响。
