Association of affective state with the assimilation of daily pain expectancy and pain experience.
Association of affective state with the assimilation of daily pain expectancy and pain experience.
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情感状态与日常疼痛预期和疼痛体验的同化之间的关联。
DOI：
10.1097/j.pain.0000000000002624
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发表时间：
2022
期刊：
影响因子：
7.4
通讯作者：
Haythornthwaite,JenniferA
中科院分区：
文献类型：
--
作者：
Finan,PatrickH;Hunt,CarlyA;Mun,ChungJung;Lerman,SheeraF;Tennen,Howard;Smith,MichaelT;Haythornthwaite,JenniferA
对疼痛和疼痛缓解的期望是安慰剂镇痛和反安慰剂痛觉过敏实验模型的核心，是慢性疼痛患者临床干预的一个有前途的目标。情感状态可能在调节预期对疼痛的影响程度，扩大干预目标的机会方面发挥重要作用。然而，迄今为止的研究结果喜忧参半，主要限于实验室设计。很少有研究探讨了自然发生的情感状态，疼痛预期和疼痛的经验，在日常生活过程中与慢性疼痛的相互作用。在这项研究中，颞下颌关节紊乱病患者报告了他们每天早上的疼痛预期和情感状态，以及他们每天晚上的疼痛体验，为期2周。多水平模型分析显示，早晨疼痛预期与随后的疼痛经历的关联受到早晨积极情感状态的调节（B 5 0.04，SE 5 0.02，t 5 2.00，P 5 0.046），因此，当早晨积极情感高于平时时，低疼痛预期与低疼痛经历的一致同化是最明显的。相关地，较高的早晨积极情绪预测经历疼痛预期和疼痛体验之间匹配的几率更大，当预期是低的，但不是高的，疼痛水平（比值比5 1.19，置信区间：1.01-1.41，P 5 0.03）。相反，负面影响并没有显着影响同化的高疼痛预期与高疼痛的经验。这些发现扩展了以前的实验研究，表明日常疼痛预期与疼痛体验的关联随着情感状态的变化而变化。
Expectancies for pain and pain relief are central to experimental models of placebo analgesia and nocebo hyperalgesia and are a promising target for clinical intervention in patients with chronic pain. Affective states may play an important role in modulating the degree to which expectancies influence pain, broadening the opportunities for intervention targets. However, findings to date have been mixed and mostly limited to laboratory designs. Few studies have examined the interplay of naturally occurring affective states, pain expectancies, and pain experiences in the course of daily life with chronic pain. In this study, patients with temporomandibular disorder reported their daily pain expectancies and affective states each morning and their daily pain experience each evening, over a 2-week period. Multilevel modeling analyses revealed the association of morning pain expectancies with subsequent pain experiences was moderated by morning positive affective state (B 5 0.04, SE 5 0.02, t 5 2.00, P 5 0.046) such that the congruent assimilation of a low pain expectancy with a low pain experience was starkest when morning positive affect was higher than usual. Relatedly, higher morning positive affect predicted greater odds of experiencing a match between pain expectancies and pain experience when the expectation was for low, but not high, pain levels (odds ratio 5 1.19, confidence interval: 1.01-1.41, P 5 0.03). Negative affect, in contrast, did not significantly influence the assimilation of high pain expectancies with high pain experiences. These findings extend previous experimental studies by showing that the association of daily pain expectancies with pain experience varies as a function of affective state.