Repressive Style, suppression and chronic Pain

压抑风格、抑制和慢性疼痛

• 批准号: 6745154
• 负责人: John W. Burns
• 金额: $ 7.8万
• 依托单位: ROSALIND FRANKLIN UNIV OF MEDICINE & SCI
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2006-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6745154
• 关键词: blood pressure; chronic disease /disorder; clinical research; electrical conductance; electromyography; human subject; pain; pain threshold; patient oriented research; repression; skin; suppression

DESCRIPTION (provided by applicant): Although repressive style has been implicated in the maintenance and exacerbation of chronic pain, its true effects and how these are exerted remain obscure and largely anecdotal. This project will test a potential mechanism with a substantial empirical basis. Because repressors show high tolerance during acute pain, but report high levels of chronic pain and respond poorly to multidisciplinary pain treatment, it was hypothesized that repressor pain patients routinely suppress pain-related thoughts and emotions and thus suffer the ironic effects of such suppression (e.g., rebound). Two pain-induction studies with patients are proposed to test whether ironic effects of thought suppression represent a mechanism by which repressive style affects chronic pain. The first study examines whether repressors spontaneously show short-term pain tolerance but long-term pain sensitivity similar to that shown by high anxious patients instructed to suppress pain (i.e., analog repressors). Chronic pain patients will undergo a cold pressor, and then be followed through recovery, and another physical stimulus (massage device); half of patients will be instructed to suppress pain during cold pressor. The second study examines whether repressors reveal a bias toward pain-related information and sensitivity to acute pain when their efforts at thought suppression are undermined by competing cognitive demands. Chronic pain patients will identify pain-related and positive words imbedded in a letter grid, and undergo a cold pressor, recovery, and the massage device; half of patients will perform these tasks with a cognitive load. Repressors' tendency to suppress the distress of pain may confer beneficial immediate effects, but habitual suppression may hide an underlying paradoxical preoccupation with pain that incurs substantial long-term physiological and psychological costs. Support for the proposed model will provide empirical justification and an impetus for confronting repressive style among pain patients. Moreover, findings should provide theoretical principles on which to found new intervention strategies (e.g., "regulating" suppression by engaging in cognitive exercises).

描述（由申请人提供）：尽管压抑风格与慢性疼痛的维持和加剧有关，但其真正的影响以及如何发挥这些影响仍然模糊且很大程度上是轶事。该项目将测试具有大量实证基础的潜在机制。由于抑制性疼痛在急性疼痛期间表现出高耐受性，但报告了高水平的慢性疼痛并且对多学科疼痛治疗反应不佳，因此假设抑制性疼痛患者通常会抑制与疼痛相关的想法和情绪，从而遭受这种抑制的讽刺效果（例如，抑制性疼痛）。 ，反弹）。两项针对患者的疼痛诱导研究旨在测试思想抑制的讽刺效应是否代表了压抑风格影响慢性疼痛的机制。第一项研究检验了抑制器是否自发地表现出短期疼痛耐受性，但长期疼痛敏感性与被指示抑制疼痛的高度焦虑患者（即模拟抑制器）所显示的相似。慢性疼痛患者将接受冷加压，然后进行康复，并接受另一种物理刺激（按摩装置）；一半的患者将被指示在冷加压期间抑制疼痛。第二项研究考察了当抑制者的思想抑制努力受到竞争性认知需求的破坏时，抑制者是否会表现出对疼痛相关信息的偏见和对急性疼痛的敏感性。慢性疼痛患者将识别嵌入字母网格中的与疼痛相关的积极词语，并接受冷压、恢复和按摩装置；一半的患者会带着认知负荷执行这些任务。抑制者抑制疼痛痛苦的倾向可能会带来有益的直接影响，但习惯性抑制可能会掩盖潜在的对疼痛的矛盾关注，从而带来大量的长期生理和心理成本。对所提出模型的支持将为对抗疼痛患者的压抑风格提供实证依据和动力。此外，研究结果应提供理论原则，据以找到新的干预策略（例如，通过参与认知练习来“调节”抑制）。