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Behavioral Conceptualization and Treatment of Chronic Pain
Annual Review of Clinical Psychology ( IF 18.4 ) Pub Date : 2020-05-08 , DOI: 10.1146/annurev-clinpsy-050718-095744
Johan W S Vlaeyen 1, 2 , Geert Crombez 3, 4
Affiliation  

Pain is considered a hardwired signal of bodily disturbance belonging to a basic motivational system that urges the individual to act and to restore the body's integrity, rather than just a sensory and emotional experience. Given its eminent survival value, pain is a strong motivator for learning. Response to repeated pain increases when harm risks are high (sensitization) and decreases in the absence of such risks (habituation). Discovering relations between pain and other events provides the possibility to predict (Pavlovian conditioning) and control (operant conditioning) harmful events. Avoidance is adaptive in the short term but paradoxically may have detrimental long-term effects. Pain and pain-related responses compete with other demands in the environment. Exposure-based treatments share the aim of facilitating or restoring the pursuit of individual valued life goals in the face of persistent pain, and further improvements in pain treatment may require a paradigm shift toward more personalized approaches.

中文翻译:


慢性疼痛的行为概念化和治疗

疼痛被认为是身体紊乱的硬连线信号,属于一个基本的动机系统,它促使个人采取行动并恢复身体的完整性,而不仅仅是一种感官和情感体验。鉴于其卓越的生存价值,痛苦是学习的强大动力。当伤害风险高时(致敏),对反复疼痛的反应增加,而在没有这种风险时(习惯化)则减少。发现疼痛与其他事件之间的关系提供了预测(巴甫洛夫条件反射)和控制(操作性条件反射)有害事件的可能性。逃避在短期内是适应性的,但矛盾的是可能会产生有害的长期影响。疼痛和与疼痛相关的反应与环境中的其他需求竞争。

更新日期:2020-05-08
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