Psychological and Neural Mechanisms of Pain Valuation

描述（由申请人提供）：医疗保健服务的有效提供取决于人们准确评估其疼痛严重程度并在需要时及时寻求医疗保健的能力。然而，实证研究已经发现了许多人们系统性地错误估计他们的痛苦的例子，经历心力衰竭的患者可能在严重的身体症状发作后延迟几个小时寻求医疗护理，通常具有致命的后果。这项研究的目的是探讨疼痛评估的心理和神经机制，并解释评估失败的原因和方式。行为和功能神经成像实验将研究（a）不同类型的疼痛评估之间的关系（例如，经验与记忆的疼痛，（B）疼痛评价的个体差异和负面情绪的性格差异之间的关系，以及（c）介导不同类型的疼痛评价对决策的影响的神经通路。通过推进我们对疼痛相关决策中涉及的心理和神经机制的理解，拟议的实验可能有助于改善临床环境中疼痛的测量，并开发新的干预措施，以提高患者疼痛相关决策的质量。公共卫生相关性：这项研究旨在了解人们在做出与疼痛相关的决定时如何确定疼痛的价值。拟议的实验有可能解释为什么人们经常对疼痛做出错误的决定，当出现严重的身体症状时，没有及时寻求医疗照顾。通过阐明与疼痛相关的决策机制，该研究有可能改善临床环境中疼痛的测量，并制定更有效的政策来识别和治疗有误报身体症状风险的个体。

DESCRIPTION (provided by applicant): Efficient delivery of health care services depends on people's ability to accurately assess the severity of their pain and seek medical care promptly when it is needed. Yet empirical studies have identified many instances in which people systematically misvalue their pain-e.g., patients experiencing heart failure may delay seeking medical attention for several hours after the onset of severe physical symptoms, often with lethal consequences. The goal of the proposed research is to investigate the psychological and neural mechanisms underlying the valuation of pain and explain why and how failures of valuation occur. Behavioral and functional neuroimaging experiments will investigate (a) the relation between different types of valuation of pain (e.g., experienced versus remembered pain, (b) the relation between individual differences in pain valuation and dispositional differences in negative affect, and (c) the neural pathways that mediate the influence of different types of pain valuation on decision-making. By advancing our understanding of the psychological and neural mechanisms involved in pain-related decision-making, the proposed experiments can potentially help to improve measurement of pain in clinical settings and develop novel interventions to enhance the quality of patients' pain-related decisions. Public health relevance: This research seeks to understand how people determine the value of their pain when making pain-related decisions. The proposed experiments have the potential to explain why it is that people often make poor decisions about pain, e.g., failing to seek prompt medical attention when experiencing severe physical symptoms. By shedding light on the mechanisms involved in pain-related decision-making, the research has the potential to improve measurement of pain in clinical settings and to develop more effective policies for identifying and treating individuals at risk for misreporting of physical symptoms.