Characteristics of Response to Experimental Pain in Sexually Abused Women
Characteristics of Response to Experimental Pain in Sexually Abused Women
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DOI：
10.1097/ajp.0b013e3182132963
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发表时间：
2011-09-01
影响因子：
2.9
通讯作者：
Yovell, Yoram
中科院分区：
文献类型：
--
作者：
Granot, Michal;Somer, Eli;Yovell, Yoram
目标：有性虐待史 (SA) 的女性通常会报告更严重的疼痛症状。目前尚不清楚疼痛敏感性增强是否是疼痛处理和反应改变的结果。因此，这项初步研究旨在探讨有严重 SA 病史的女性对实验诱发疼痛的疼痛敏感性以及相关心理。方法：21 名严重、持久 SA 的幸存者和 21 名对照女性接受了实验诱发的热痛并完成了心理问卷。疼痛测量包括热痛阈值、疼痛强度等级以及对接触热、传递到前臂掌侧的疼痛刺激的疼痛耐受性。问卷包括躯体化（简要症状量表）、人格特征，包括避免伤害、寻求新奇和奖励依赖（Cloninger 三维人格问卷）以及解离程度（解离体验量表）。结果：SA 女性的热痛阈值升高（45.7 +/- 2.21 摄氏度 vs. 43.9 +/- 3.11 摄氏度；P = 0.042）或更高疼痛强度评级（0 到 100 等级：80.0 +/- 26.6 对比 51.2 +/- 27.7；P = 0.001）。此外，他们对疼痛性强直刺激的耐受性较低，躯体化程度较高，避免伤害得分较高。回归分析表明，SA 女性较高的疼痛强度评级与更大的避免伤害倾向相关，但与解离程度无关。讨论：有严重 SA 病史的女性似乎具有矛盾的实验性疼痛反应模式，其特征是较高的疼痛阈值和较高的疼痛强度评级。这种模式与避免伤害的人格特质有关。讨论了可能解释这些发现的模型。
Objectives: Women with a history of sexual abuse (SA) commonly report greater pain symptoms. It is still unclear whether enhanced pain susceptibility is the result of altered pain processing and response. Therefore, this pilot study aimed to explore pain sensitivity to experimentally induced pain and associated psychology in women with a history of severe SA.Methods: Twenty-one survivors of severe, long-lasting SA and 21 control women underwent experimentally induced heat pain and completed psychological questionnaires. Pain measures included heat pain thresholds, pain intensity ratings, and pain tolerance in response to contact heat, painful stimulation delivered to the volar forearm. Questionnaires included somatization (Brief Symptom Inventory), personality traits including harm avoidance, novelty seeking, and reward dependence (Cloninger tridimensional personality questionnaire), and levels of dissociation (Dissociative Experiences Scale).Results: SA women had elevated heat pain thresholds (45.7 +/- 2.21 degrees C vs. 43.9 +/- 3.11 degrees C; P = 0.042) and higher pain intensity ratings (on a 0 to 100 scale: 80.0 +/- 26.6 vs. 51.2 +/- 27.7; P = 0.001). In addition, they had lower tolerability to painful tonic stimulation, greater somatization, and larger harm avoidance scores. Regression analyses showed that higher pain intensity ratings in SA women associated with greater tendency for harm avoidance but not with levels of dissociation.Discussion: Women with a history of severe SA seem to have a paradoxical pattern of experimental pain response, characterized by both higher pain thresholds and increased pain intensity ratings. This pattern is associated with the personality trait of harm avoidance. Models that might account for these findings are discussed.