Ruoss M
Psychologisches Institut der Universität Bonn.
Z Exp Psychol. 1997;44(4):561-88.
Research on pain-related cognitions has up to now predominantly relied upon introspective questionnaire data. Experimental cognitive psychology offers an alternative way of access to the cognitive aspects of chronical pain. Building on the assumption that information-processing is in part uncontrolled, automatic and pre-attentive, similar processes are also expected to be relevant for pain-relevant cognitions and to be involved in health-related convictions and in coping strategies that can be assessed with questionnaires. Cognitive-psychological research has established the "hindsight bias" as a robust phenomenon that occurs uncontrolled and automatically in diverse contexts when a prior judgment or prediction is assimilated to information received later on. The hindsight bias may be regarded as a manifestation of a universal cognitive mechanism, meaning that information (including information about emotional states) available at a given time will change the memory of prior judgments or of predictions of future events and results of behavior. Cognitive biases similar to the hindsight effect have been demonstrated in chronical pain patients. The present work elaborates the hypothesis that pain patients differ from other groups in the size of the hindsight bias and in its composition and outlines how it can contribute to the chronification of pain. Data from a hindsight-bias experiment comparing pain patients, psychiatric patients and students are analyzed using alternatively a traditional global hindsight bias score ("Hell-Index") and a multinomial modelling approach. The hindsight-effect was observed in the usual extent in the student control group, but was significantly greater in the pain group and absent in the psychiatric sample. In addition to this global finding, multinomial modelling revealed group differences in specific model parameters. This method of analysis thus proved as promising for the assessment of cognitive aspects of clinical disorders.
迄今为止，有关疼痛相关认知的研究主要依赖于内省问卷调查数据。实验认知心理学提供了一种了解慢性疼痛认知方面的替代方法。基于信息处理部分是不受控制、自动且先于注意力的这一假设，类似的过程也被认为与疼痛相关认知有关，并参与到可通过问卷调查评估的健康相关信念和应对策略中。认知心理学研究已将“后见之明偏差”确立为一种强大的现象，当先前的判断或预测被吸收到后来获得的信息中时，它会在不同情境中不受控制且自动地出现。后见之明偏差可被视为一种普遍认知机制的表现，这意味着在给定时间可得的信息（包括有关情绪状态的信息）会改变对先前判断或未来事件及行为结果预测的记忆。在慢性疼痛患者中已证实存在与后见之明效应类似的认知偏差。本研究详细阐述了这样一个假设：疼痛患者与其他群体在后见之明偏差的大小及其构成方面存在差异，并概述了它如何导致疼痛的慢性化。分别使用传统的整体后见之明偏差分数（“地狱指数”）和多项式建模方法，对一项比较疼痛患者、精神科患者和学生的后见之明偏差实验的数据进行了分析。在学生对照组中观察到了通常程度的后见之明效应，但在疼痛组中显著更大，而在精神科样本中则不存在。除了这一整体发现外，多项式建模还揭示了特定模型参数中的组间差异。因此，这种分析方法被证明在评估临床疾病的认知方面很有前景。
