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)对临床疼痛的处理已经在临床上得到了证明 结果研究将有效地减轻因临床不同而引起的疼痛 条件。虽然这些方法越来越多地被倡导为主要或 辅助性疼痛治疗，对其机制知之甚少(S) 这些方法有助于减轻疼痛。此应用程序提出了一系列 对实验室疼痛的研究旨在增加我们对疼痛的了解 行为的改变会如何影响疼痛。 我们接受现在被广泛接受的观点，即疼痛是一个多维的 结构，由感官和反应成分组成，并具有 考察了疼痛强度与其对 对患者进行描述性和临床结局研究。这些研究 给我们留下了深刻的印象，可能是多种因素 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异议 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 包括诱发皮层电位在内的几种反应途径，自主神经 和肌电活动，以及耐受性等主观指标 和强度等级，(3)使用实验任务，其中活动 受试者处于最大限度的实验控制之下，受试者为表演受试者 为了测量。 我们将研究注意力/分心、背景肌肉的影响 活动性和大脑皮层觉醒对牙髓反应的测量 和/或冷性升压痛。我们将开发一个实验室情绪模型 归纳研究情绪状态对实验室疼痛的影响。我们会 尝试改进面部表情作为疼痛指标的测量方法 严肃性。最后，我们将测试特定的认知策略，这两种策略 在没有催眠诱导的情况下，我们在实验室的疼痛模型上 发展起来的。

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.