LABORATORY STUDIES OF PAIN CONTROL METHODS

使用行为方法（包括生物反馈和放松 培训，强化疗法，认知控制技术和 催眠）在临床疼痛管理中的作用已在临床中得到证实。 由于不同的临床表现，结局研究可有效减轻疼痛 条件 虽然这些方法越来越多地被提倡为主要的或 对于连续性疼痛疗法，人们对其机制知之甚少， 这些方法用于减轻疼痛。 本申请提出了一系列 对实验室疼痛的研究， 行为改变如何影响疼痛 我们接受现在广泛持有的立场，即疼痛是一个多维度的， 结构，由感觉和反应成分组成，并具有 研究了疼痛强度与其对 描述性和临床结局研究中的患者。 这些研究 给我们留下了深刻的印象， 负责疼痛的行为控制 虽然认识到从实验室疼痛模型到 临床疼痛是困难的，我们将尝试满足一些反对意见， 通过（1）使用两种类型的实验室疼痛， 牙髓刺激和冷加压刺激，（2）测量 几个反应通道，包括诱发皮层电位，自主神经 和肌电图活动，以及主观测量，如耐受性， 和强度评级，（3）使用实验任务，其中活动的 受试者处于最大的实验控制之下， 到测量。 我们将研究注意力/分心，背景肌肉 活动和皮质电唤醒对牙髓反应的测量 和/或冷加压痛。 我们将开发一个实验室情绪模型 诱导以检查情绪状态对实验室疼痛的影响。 我们将 试图改进面部表情的测量，作为疼痛的指标 严重性。 最后，我们将测试特定的认知策略， 在没有催眠诱导的情况下， 开发

The use of behavioral methods (which include biofeedback and relaxation training, reinforcement therapies, cognitive control techniques and hypnosis) in the management of clinical pain have been shown in clinical outcome studies to be effective in reducing pain due to diverse clinical conditions. While these methods are increasingly advocated as primary or adjunctive pain therapies, little is known about the mechanism(s) by which such methods serve to reduce pain. This application proposes a series of studies of laboratory pain that are designed to increase our understanding of how changes in behavior might effect pain. We accept the now widely-held position that pain is a multi-dimensional construct, composed of both sensory and reactive components, and have examined the relationship between the intensity of pain and its impact upon the patients in descriptive and clinical outcome studies. These studies have impressed us with the multiplicity of factors that could be responsible for behavioral control of pain. While recognizing that generalization from laboratory pain models to clinical pain is difficult, we will attempt to meet some of the objections raised to previous studies by (1) using two types of laboratory pain, stimulation of the tooth pulp and cold pressor stimulation, (2) measuring several response channels, including evoked cortical potentials, autonomic and electromyographic activity, and subjective measures such as tolerance and intensity ratings, (3) using experimental tasks where the activity of the subject is under maximal experimental control, with performance subject to measurement. We will examine the effects of attention/distraction, background muscle activity, and electrocortical arousal on measures of response to tooth pulp and/or cold pressor pain. We will develop a model of laboratory mood induction to examine the effects of mood state on laboratory pain. We will attempt to refine measures of facial expression as indicators of pain severity. Finally, we will test specific cognitive strategies, both with and without hypnotic induction, on the laboratory pain models we have developed.