恐惧的代价:疼痛恐惧、心理忧虑和躯体化对疼痛感知预测作用的比较  

Pain- Related Fear: Dominance in Pain Perception over Psychological Distress and Somatization among Young Adults in China

作　　者：张西磊[1] Todd Jackson 陈红[1] 杨周[1] 

机构地区：[1]西南大学心理学部,认知与人格教育部重点实验室,重庆400715

出　　处：《心理科学》2014年第1期53-59,共7页Journal of Psychological Science

基　　金：国家自然科学基金项目(31371037);211工程国家重点学科建设项目(NSKD11005);重庆百名海内外高层次人才聚集计划的资助

摘　　要：首次在无痛群体中比较疼痛恐惧、心理忧虑和躯体化对疼痛感知的预测作用大小及调节和中介关系。以多个同类量表得分的Z分数加和作为三者的因子分,以冷压痛觉测验(CPT)疼痛指标(阈限、耐受性、强度、不愉快度)为目标变量,通过分层回归及调节和中介作用分析,发现疼痛恐惧对疼痛不愉快度的预测作用最强,心理忧虑对疼痛体验(强度、不愉快度)的预测作用被疼痛恐惧完全中介,躯体化只有在高疼痛恐惧条件下才显著负向预测疼痛不愉快度。综上,疼痛恐惧是三因素中预测CPT疼痛体验的主要因素。Pain perception, including nociceptive component, sensory discriminative component （intensity）, motivational affective component （unpleasantness） and cognitive behavioral component, may be influenced by psychological factors such as pain related fear, psychological distress, and somatization. Though effect on pain perception of pain related fear has been widely confirmed and thus based its effect on chronic pain initiation, development and maintenance, no studies have yet assured its dominance against other psychological factors such as psychological distress and somatization. One methodological concern about the research in the area is a re liance on using single scales to measure complex constructs such as psychological distress and pain related fear. Furthermore, the ma jority of studies have used chronic pain samples, so it is not clear whether possible elevations in somatization, psychological distress and pain related fear influenced pain perception or resulted from experiences of ongoing pain. This cross sectional research was designed to clarify these issues within a general university student sample. A pilot study was designed to evaluate the structure and distinctiveness of somatization, psychological distress and pain related fear using multiple rather than single measures to represent each factor. Then, the impact of each of these psychological dimensions on pain perception was evaluated within a laboratory pain paradigm. A total of 653 university students （69.60% female） completed a battery of five pain related fear scales, three measures of psy chological distress not specifically related to pain, and two somatization scales. Exploratory factor analysis （EFA） and confirmatory fac tor analyses （CFA） were conducted on random equal subsets of the total sample to determine whether initially derived factor solutions were replicable in a new group. Eight weeks later, 105 participants （70.45% female） completed the questionnaire battery and the Cold Pressor Test （CPT） , wit

关 键 词：疼痛 疼痛恐惧 心理忧虑 躯体化 冷压痛觉测验 中介效应 调节效应 

分 类 号：B842[哲学宗教—基础心理学]