Reduced selective learning in patients with fibromyalgia vs healthy controls
Reduced selective learning in patients with fibromyalgia vs healthy controls
复制标题
与健康对照相比，纤维肌痛患者的选择性学习减少
作者：
A. Meulders;Y. Boddez;Fernando Blanco;M. Van Den Houte;J. Vlaeyen
选择性恐惧学习受损被认为是慢性疼痛患者疼痛相关恐惧和回避等保护性反应过度扩散的核心机制。使用选择性学习效应的石蕊试验，阻断程序，我们验证了纤维肌痛（FM）患者比健康对照组（hc）表现出更少的选择性威胁学习的假设。我们介绍了一种新的基于临床日记场景的选择性学习任务。在一个接一个试验的基础上，参与者评估他们是否预期FM患者日记中的某些情况（a， B， Z和X）会引发该患者的疼痛。该过程不涉及任何实验性疼痛诱导，因为使用了口头结果“疼痛”或“无痛”。在基本习得阶段，一种情况之后是“疼痛”（A+，例如，“Kim睡得不好，报告疼痛”），而另一种情况之后是“没有疼痛”（Z -，例如，“Kim压力很大，报告没有疼痛”）。在复合获得阶段，另一种情况(X)，被称为阻断刺激，与先前引起疼痛的情况复合呈现，并与“疼痛”配对（AX+，例如，Kim睡得不好”和“Kim吸尘”，并报告疼痛）。同时，游戏引入了一种新的情境，并伴随着“痛苦”（B+）。组内比较显示hc有阻滞（即B和X有显著差异），但FM患者没有。这项研究首次直接评估了FM患者和hcc患者在选择性学习方面的差异。
Abstract Impaired selective fear learning has been advanced as a core mechanism involved in excessive spreading of protective responses such as pain-related fear and avoidance leading to disability in chronic pain conditions. Using the litmus test for selective learning effects, the blocking procedure, we tested the hypothesis that patients with fibromyalgia (FM) show less selective threat learning than healthy controls (HCs). We introduce a novel selective learning task based around a clinical diary scenario. On a trial-by-trial basis, participants rated whether they expected certain situations (A, B, Z, and X) in the diary of a fictive FM patient would trigger pain in that patient. The procedure did not involve any experimental pain induction because the verbal outcomes “pain” or “no pain” were used. During the elemental acquisition phase, one situation was followed by “pain” (A+, eg, “Kim slept badly, and reports pain”), whereas another situation was followed by “no pain” (Z−, eg, “Kim was stressed, and reports no pain”). During the compound acquisition phase, another situation (X), referred to as the blocked stimulus, was presented in compound with a previously pain-eliciting situation and also paired with “pain” (AX+, eg, Kim slept badly” and “Kim has vacuumed,” and reports pain). Simultaneously, a novel situation was introduced and also followed by “pain” (B+). Within-group comparisons showed blocking (ie, significant difference between B and X) in the HCs, but not in the patients with FM. This study is the first in directly assessing differences in selective learning between patients with FM and HCs using a blocking procedure.
影响因子：
4.1
作者：
Lissek S;Rabin SJ;McDowell DJ;Dvir S;Bradford DE;Geraci M;Pine DS;Grillon C
通讯作者：
Grillon C
DOI：
10.1176/appi.ajp.2009.09030410
发表时间：
2010-01
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Lissek S;Rabin S;Heller RE;Lukenbaugh D;Geraci M;Pine DS;Grillon C
通讯作者：
Grillon C