Ohrbach R, Blascovich J, Gale E N, McCall W D, Dworkin S F
Department of Oral Diagnostic Sciences, University at Buffalo, NY 14214, USA.
J Dent Res. 1998 Oct;77(10):1840-50. doi: 10.1177/00220345980770101201.
Due to disparate findings across the published studies, the stress-hyperactivity hypothesis has never been fully accepted as a causal mechanism for chronic muscle pain. Two recent comprehensive reviews of the psychophysiological studies of chronic pain came to opposite conclusions about the viability of the hypothesis, which stemmed from differing importance placed on the experimental methodology: the adequacy of stress manipulation. The present study tested the hypotheses that the adequacy of stress manipulation is influenced by stress stimuli type, degree of personal relevance, and selection of criterion for verification of stress experience, and that these factors have a measurable impact on the related physiological responses in a manner that is consistent with a theory of stress applicable to clinical stress disorders. The three factors investigated were: task (imagery, reaction time), relevance (high, low), and manipulation criterion (autonomic, self-report). The tasks were presented to 16 chronic pain patients while muscle, electrodermal, and self-report responses were recorded. Reaction-time tasks and high-relevance conditions led to high muscle and electrodermal responses. Only the high-relevance imagery, however, produced high self-reported distress. Consistent with other research, the present overall data demonstrated differing physiological profiles for different stimuli types. More importantly, these data suggest that the manipulation type and the manipulation criterion influence outcomes of experimental tests of stress on physiological systems, which may directly lead to contrasting conclusions about causal relations between stress and chronic pain conditions.
由于已发表研究的结果存在差异，应激-多动假说从未被完全接受为慢性肌肉疼痛的因果机制。最近两项关于慢性疼痛心理生理学研究的综合综述，就该假说的可行性得出了相反的结论，这源于对实验方法（即应激操纵的充分性）的重视程度不同。本研究检验了以下假说：应激操纵的充分性受应激刺激类型、个人相关程度以及应激体验验证标准选择的影响，并且这些因素以与适用于临床应激障碍的应激理论相一致的方式，对相关生理反应产生可测量的影响。所研究的三个因素为：任务（想象、反应时间）、相关性（高、低）和操纵标准（自主神经、自我报告）。在向16名慢性疼痛患者呈现任务的同时，记录肌肉、皮肤电和自我报告反应。反应时间任务和高相关性条件导致较高的肌肉和皮肤电反应。然而，只有高相关性的想象产生了较高的自我报告痛苦。与其他研究一致，目前的总体数据表明不同刺激类型具有不同的生理特征。更重要的是，这些数据表明，操纵类型和操纵标准会影响应激对生理系统实验测试的结果，这可能直接导致关于应激与慢性疼痛状况之间因果关系的不同结论。
