Does a diagnosis of depression influence observer ratings of pain severity? The mediating role of causal attributions of pain and pain genuineness

IF 1.3 Q4 CLINICAL NEUROLOGY British Journal of Pain Pub Date : 2023-10-18 DOI:10.1177/20494637231206541
Kara Turcotte, Susan Holtzman
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Abstract

Researchers have been increasingly investigating observer and patient characteristics that may influence the assessment of pain in others. While rates of psychiatric conditions are high in chronic pain populations, surprisingly little attention has been given to if (and why) a comorbid psychiatric diagnosis may influence the estimation of pain in others. Using an experimental vignette paradigm, the current study examined whether a diagnostic label of major depressive disorder (MDD) would impact observer pain estimates of a woman with chronic pain, and whether causal attributions of pain and pain genuineness might help explain these effects. Participants ( n = 188) were given a vignette describing a female patient with chronic pain (who either had MDD or no mental health concerns), viewed a brief video clip of the patient, and then were asked to provide a variety of ratings about the woman’s pain. Results of a serial multiple mediation analysis revealed that participants in the MDD condition made greater psychological attributions for the woman’s pain, which was associated with lower perceptions of pain genuineness, which was then associated with lower estimates of pain intensity. These findings suggest that a diagnosis of depression may indirectly influence observer estimates of another person’s pain by heightening psychological attributions of pain, and making their pain seem less genuine. Further research is needed to elucidate the complex processes underlying pain estimation, including patient and observer characteristics, biases, and heuristics, in order to improve quality of care for those living with persistent pain.’
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抑郁症的诊断会影响观察者对疼痛严重程度的评价吗?疼痛的因果归因和疼痛真实性的中介作用
研究人员越来越多地研究可能影响他人疼痛评估的观察者和患者特征。虽然慢性疼痛人群中精神疾病的发病率很高,但令人惊讶的是,很少有人关注是否(以及为什么)共病精神诊断可能会影响其他人对疼痛的估计。本研究采用实验小插图范例,研究重度抑郁症(MDD)的诊断标签是否会影响观察者对慢性疼痛女性的疼痛估计,以及疼痛和疼痛真实性的因果归因是否有助于解释这些影响。研究人员给参与者(n = 188)看了一个描述慢性疼痛女性患者(患有重度抑郁症或没有精神健康问题)的小短文,观看了该患者的简短视频片段,然后被要求对该女性的疼痛进行各种评分。一系列多重中介分析的结果显示,重度抑郁症的参与者对女性的疼痛有更大的心理归因,这与较低的疼痛真实性感知有关,然后与较低的疼痛强度估计有关。这些发现表明,抑郁症的诊断可能会间接影响观察者对另一个人的痛苦的估计,因为它会加强对痛苦的心理归因,并使他们的痛苦看起来不那么真实。需要进一步的研究来阐明疼痛评估的复杂过程,包括患者和观察者的特征、偏见和启发式,以提高对那些患有持续性疼痛的人的护理质量。”
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来源期刊
British Journal of Pain
British Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.20
自引率
11.10%
发文量
42
期刊介绍: British Journal of Pain is a peer-reviewed quarterly British journal with an international multidisciplinary Editorial Board. The journal publishes original research and reviews on all major aspects of pain and pain management. Reviews reflect the body of evidence of the topic and are suitable for a multidisciplinary readership. Where empirical evidence is lacking, the reviews reflect the generally held opinions of experts in the field. The Journal has broadened its scope and has become a forum for publishing primary research together with brief reports related to pain and pain interventions. Submissions from all over the world have been published and are welcome. Official journal of the British Pain Society.
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