正念训练干预疼痛感受的心理机制研究

Chronic pain can contribute to severe and even relentless suffering on individuals, and an heavy burden on the whole society, which need more research on mechanism and interventions. Mindfulness training, which originated from eastern culture, showed stable effect in reducing pain related suffering. However, the psychological mechanism of mindfulness training for pain suffering is still unclear, which restricts the new develop of interventions for pain suffering. Combined "Observe as it is", which is core of mindfulness, with the "Fear-Avoidance" model of chronic pain, the present application proposed "Observe-Confrontation", the psychological mechanism for mindfulness training on chronic pain. That is, after mindfulness training, individuals show more observation and acceptance on pain, and enhance cognitive reappraisal for pain stimuli, and reduce pain catastrophizing. Then, fear for pain will decrease, and confrontation to pain will increase.All these will help individual get more possibility to recover from pain finally. Focus on this model, the present application proposes to adopt Experience Sampling Method, dot probe task, and brain EEG to test whether mindfulness training increase observation, acceptance, cognitive reappraisal for pain, decrease attentional bias to pain related stimuli, and affect brain function in processing pain related stimuli. These experiments may deepen our understanding of psychological mechanism of recovery from chronic pain, and help to develop a pain recovery model " Observe-Confrontation". These result may have important contribution on theory of pain recovery and may help researchers to develop more focus, shorter and effective psychological interventions for pain suffering.

慢性疼痛对患者影响巨大，给社会造成沉重负担，需要不断深入探讨其康复的方法与机制。正念训练对慢性疼痛的康复效果获得一定的实证研究支持，然而，其康复的心理机制尚不清楚，制约了干预方案的进一步发展。本申请在疼痛的"恐惧-回避"模型基础上，结合正念"如实观察"的核心，提出疼痛走向康复的"观察-面对"心理机制：个体对疼痛刺激与感受的接纳和观察，使个体增加对刺激和疼痛的认知重评，减少灾难化认知加工和对疼痛的恐惧，增加面对与理性处理疼痛的可能性，最终增加个体走向康复的可能性。围绕此理论机制，本申请拟采用经验取样法、点探测任务及大脑皮层电位，分别检验正念训练对于冷压任务唤起疼痛的观察、接纳、对疼痛的有害性认知评估，以及对于疼痛相关刺激的注意偏向及脑功能的影响。研究结果有望发展制定疼痛的"观察-面对"康复模型，对疼痛康复的心理机制做出重要理论贡献，为制定更为聚焦和短程的干预方案提供参考。

本项目按照前期设计和计划安排，有序开展了各项研究工作，取得了多项发现。截至目前，共计发表学术论文16篇，其中SCI收录杂志论文2篇，SSCI收录杂志4篇。研究发现包括：经过8周正念训练可以显著提升参与者对疼痛的接纳程度以及内心平静程度，短期正念训练，可以显著缓解被试内心痛苦程度。正念缓解疼痛感受的心理机制中，接纳是一个重要因素。对于疼痛的接纳，能够帮助个体面对疼痛，减少疼痛的困扰。另外，接纳在正念与内心平静、知觉压力以及主观幸福感之间存在中介作用。其他研究还发现，正念训练使得服刑人员的攻击性及睡眠的改善，正念训练能提升个体幸福感。这些研究结果对于本研究项目试图发现并提出疼痛康复的“观察-面对”机制，给出了初步的实验证据。但是遗憾的是，我们并没有发现正念对被试对疼痛相关刺激的注意偏向产生了影响，因此无法进一步探索相关脑电活动差异。