Generalized hypervigilance in fibromyalgia: Evidence of perceptual amplification
Generalized hypervigilance in fibromyalgia: Evidence of perceptual amplification
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DOI：
10.1016/0304-3959(96)03059-x
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发表时间：
1996-08-01
期刊：
影响因子：
7.4
通讯作者：
McCain, GA
中科院分区：
文献类型：
--
作者：
McDermid, AJ;Rollman, GB;McCain, GA
痛觉的超警觉模型表明，慢性疼痛患者对疼痛的敏感性提高（如低阈值和耐受性），因为他们对外部刺激的关注增加，对疼痛感觉的关注增加。本研究验证了纤维肌痛（一种来源不明的慢性疼痛障碍）患者的假设，即他们有一种超越疼痛领域的广泛性高度警觉的反应模式。20例纤维肌痛门诊患者、20例类风湿关节炎（RA）患者和20例正常人作为研究对象。RA和正常对照组的年龄和性别与纤维肌痛患者相匹配。研究人员测试了受试者的疼痛耐受性、疼痛阈值和噪音耐受性，并要求他们完成一系列评估过度警觉性的问卷。正如预测的那样，纤维肌痛患者对疼痛和听觉刺激的反应与广泛性高警觉性假设一致。这些患者的阈值和耐受性值明显低于RA患者，RA患者的阈值和耐受性值也低于正常对照组。心理问卷调查结果显示，纤维肌痛患者和RA患者对外部刺激水平的偏好低于正常对照组。本研究的结果支持广义高警觉性假说，表明纤维肌痛患者有一种感知型放大。这些发现对理解疼痛障碍中生物、认知和知觉因素的作用的意义进行了讨论。
The hypervigilance model of pain perception states that chronic pain patients have a heightened sensitivity to pain (e.g. low threshold and tolerance) because of increased attention to external stimulation and a preoccupation with pain sensations. This study tested the hypothesis that individuals with fibromyalgia, a chronic pain disorder of undetermined origin, have a generalized hypervigilant pattern of responding that extends beyond the pain domain. Twenty fibromyalgia out-patients, 20 rheumatoid arthritis (RA) patients, and 20 normal controls served as subjects. The RA and normal control subjects were age and sex matched to the fibromyalgia patients. Subjects were tested for pain tolerance, pain threshold, and noise tolerance and were asked to complete a number of questionnaires that assessed hypervigilance. As predicted, the responses of the fibromyalgia patients to both the pain and auditory stimuli were consistent with the generalized hypervigilance hypothesis. These patients had significantly lower threshold and tolerance values than the RA patients, who in turn, had lower values than the normal control subjects, The results of the psychological questionnaires revealed that the fibromyalgia and RA patients preferred lower levels of external stimulation than the control subjects. The outcome of this study supports the generalized hypervigilance hypothesis, suggesting that fibromyalgia patients have a perceptual style of amplification. The implications of these findings for understanding the role of biological, cognitive, and perceptual factors in pain disorders are discussed.