健康与遗传心理学研究室知识库

    疼痛恐惧是疼痛基础和临床研究中的一个重要课题。个体对疼痛信息产生过度警觉,  诱发不恰当的回避行为,  扰乱机体的正常功能,  加剧疼痛的现象即为疼痛恐惧。 疼痛恐惧可影响个体的疼痛感知以及疼痛相关的注意和回避行为,  且在慢性疼痛(如慢性肌骨骼疼痛)的发展、 维持个体正常生理功能的丧失中起着重要作用。疼痛恐惧的形成与表达涉及杏仁核、海马、背侧前扣带回皮层、和前额叶皮层等脑区的参与。当前的疼痛恐惧消退的心理−行为干预方法可在疼痛恐惧加工的不同阶段(巩固、再巩固和消退)消退个体的疼痛恐惧。然而,  由于恐惧记忆形成过程较为复杂并受多种因素影响,  疼痛恐惧记忆消退方法效果较不稳定,  其基础研究与临床应用之间仍存在较大的鸿沟。将来研究有必要考虑到疼痛恐惧形成环境的差异以及个体人格特质/心理状态的差异,  逐步完善相关消退方法并将其引入临床镇痛,  以期帮助患者弱化、 擦除甚至改写困扰他们的疼痛恐惧,  从而缓解甚至消除病患的疼痛。

    Pain-related fear is an important topic in both basic and clinical research of pain. It is associated with pain hypervigilance and followed by avoidance behaviors, thereby resulting in the inaccurate processing of non-pain-related information, the disturbance of the body functions, as well as the exacerbation of pain disability. Individual pain-related fear can influence subjective pain perception and pain-related attention bias and avoidance behavior, as well as plays an important role in the development of chronic pain (e.g., chronic musculoskeletal pain) and the maintenance of physiological dysfunctions. Multiple cortical and sub-cortical brain regions, e.g., amygdala, hippocampus, dorsal anterior cingulate cortex, and prefrontal cortex, involve in the formation and expression of pain-related fear. Existing psychological-behavioral intervention therapies of reducing pain-related fear worked in different stages of pain-related fear formation (consolidation, reconsolidation, and extinction). Nevertheless, due to the complexity of pain-related fear formation and the influences of multiple factors, the effect of current psychological intervention therapies for reducing pain-related fear is not stable, yet there is a great gap between the relevant basic research and clinical applications. Differences of contexts in the formation of pain-related fear, as well as individual personality traits and psychological states, should be well taken into consideration in the future study, which will help reduce or even eliminate the disturbing pain-related fear, thus relieving and removing pain sufferings.