Perceived self-efficacy and pain control: opioid and nonopioid mechanisms.
Perceived self-efficacy and pain control: opioid and nonopioid mechanisms.
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DOI：
10.1037//0022-3514.53.3.563
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发表时间：
1987-09
影响因子：
7.6
通讯作者：
A. Bandura;A. O'Leary;C. Taylor;J. Gauthier;D. Gossard
中科院分区：
文献类型：
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作者：
A. Bandura;A. O'Leary;C. Taylor;J. Gauthier;D. Gossard
在这个实验中，我们测试了阿片类和非阿片类药物的疼痛控制机制，通过认知手段和阿片类药物参与感知应对效能的关系。受试者被教导疼痛控制的认知方法，给予安慰剂，或不接受任何干预。然后，在给他们注射生理盐水或纳洛酮（一种阻断内源性阿片作用的阿片拮抗剂）后，定期测量他们的疼痛耐受性。认知控制训练加强了自我效能感，以承受和减少疼痛;安慰剂药物增强了自我效能感，以承受疼痛，但不减少效能感;没有任何形式的自我效能感的改变，没有任何干预。无论条件，较强的自我效能感，以承受疼痛，较长的受试者忍受不断增加的疼痛刺激。这些发现提供了证据表明，通过认知控制减轻疼痛刺激的影响是由阿片类和非阿片类机制介导的。接受纳洛酮治疗的认知障碍者比接受生理盐水治疗的认知障碍者更难忍受疼痛刺激。减轻疼痛的自我效能感越强，阿片样物质的激活就越大。即使阿片机制被纳洛酮阻断，认知copers也能够实现疼痛耐受性的一些增加，这与认知疼痛控制中的非阿片成分一致。我们发现暗示性证据表明安慰剂药物也可能激活一些阿片类药物的参与。由于安慰剂不传授减轻疼痛的技能，它被认为是自我效能，以忍受疼痛，预测阿片类药物激活的程度。
In this experiment, we tested for opioid and nonopioid mechanisms of pain control through cognitive means and the relation of opioid involvement to perceived coping efficacy. Subjects were taught cognitive methods of pain control, were administered a placebo, or received no intervention. Their pain tolerance was then measured at periodic intervals after they were administered either a saline solution or naloxone, an opiate antagonist that blocks the effects of endogenous opiates. Training in cognitive control strengthened perceived self-efficacy both to withstand and to reduce pain; placebo medication enhanced perceived efficacy to withstand pain but not reductive efficacy; and neither form of perceived self-efficacy changed without any intervention. Regardless of condition, the stronger the perceived self-efficacy to withstand pain, the longer subjects endured mounting pain stimulation. The findings provide evidence that attenuation of the impact of pain stimulation through cognitive control is mediated by both opioid and nonopioid mechanisms. Cognitive copers administered naloxone were less able to tolerate pain stimulation than were their saline counterparts. The stronger the perceived self-efficacy to reduce pain, the greater was the opioid activation. Cognitive copers were also able to achieve some increase in pain tolerance even when opioid mechanisms were blocked by naloxone, which is in keeping with a nonopioid component in cognitive pain control. We found suggestive evidence that placebo medication may also activate some opioid involvement. Because placebos do not impart pain reduction skills, it was perceived self-efficacy to endure pain that predicted degree of opioid activation.