Psychologic influence on experimental pain sensitivity and clinical pain intensity for patients with shoulder pain.
Psychologic influence on experimental pain sensitivity and clinical pain intensity for patients with shoulder pain.
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DOI：
10.1016/j.jpain.2008.09.004
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Hirsh AT
中科院分区：
文献类型：
--
作者：
George SZ;Hirsh AT
疼痛相关恐惧和疼痛灾难化是恐惧 - 回避模型中的两个核心心理因素。我们之前在健康受试者中的研究表明，疼痛相关恐惧而非疼痛灾难化与冷压痛结果相关。当前的研究通过对一组肩痛受试者的疼痛相关恐惧和疼痛灾难化进行调查，并纳入对实验性疼痛和临床疼痛的同步测量，扩展了先前的工作。本研究招募了59名连续寻求肩痛手术治疗的受试者（24名女性，平均年龄 = 50.4岁，标准差 = 14.9）。受试者完成了经过验证的疼痛相关恐惧、疼痛灾难化以及临床疼痛强度的测量，然后接受冷压任务以确定实验性疼痛敏感性。多元回归模型使用性别、年龄、疼痛相关恐惧和疼痛灾难化来预测实验性疼痛敏感性和临床疼痛强度。结果表明，只有疼痛相关恐惧对实验性疼痛敏感性的方差有独特贡献（β = -0.42，p < 0.01）。相比之下，性别（β = -0.29，p = 0.02）和疼痛灾难化（β = 0.43，p < 0.01）对临床疼痛强度的方差有独特贡献。这些数据为将恐惧 - 回避模型应用于肩痛受试者提供了额外支持。我们的结果还表明，疼痛相关恐惧和疼痛灾难化可能影响疼痛体验的不同组成部分，为疼痛灾难化作用的近期理论概念化提供了初步支持。
Pain-related fear and pain catastrophizing are two central psychologic factors in fear-avoidance models. Our previous studies in healthy subjects indicated that pain-related fear, but not pain catastrophizing, was associated with cold pressor pain outcomes. The current study extends previous work by investigating pain-related fear and pain catastrophizing in a group of subjects with shoulder pain, and included concurrent measures of experimental and clinical pain. Fifty nine consecutive subjects seeking operative treatment of shoulder pain were enrolled in this study (24 females, mean age = 50.4, sd = 14.9). Subjects completed validated measures of pain-related fear, pain catastrophizing, and clinical pain intensity and then underwent a cold pressor task to determine experimental pain sensitivity. Multivariate regression models used sex, age, pain-related fear, and pain catastrophizing to predict experimental pain sensitivity and clinical pain intensity. Results indicated that only pain-related fear uniquely contributed to variance in experimental pain sensitivity (beta = −.42, p < .01). In contrast, sex (beta = −.29, p = .02) and pain catastrophizing (beta = .43, p < .01) uniquely contributed to variance in clinical pain intensity. These data provide additional support for application of fear-avoidance models to subjects with shoulder pain. Our results also suggest that pain-related fear and pain catastrophizing may influence different components of the pain experience, providing preliminary support for recent theoretical conceptualizations of the role of pain catastrophizing.
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