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  • 한국과학기술정보연구원(KISTI) 서울분원 대회의실(별관 3층)
  • 2024년 07월 03일(수) 13:30
 

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통증관련 단어에 대한 주의편향이 만성통증 환자의 일일 통증강도와 일상기능 관계에 미치는 영향: 일지연구

Effects of attentional biases on pain-related words on daily function in patients with chronic pain: a diary study

한국심리학회지: 건강 / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2020, v.25 no.5, pp.955-974
https://doi.org/10.17315/kjhp.2020.25.5.006
김혜지 (충남대학교병원)
정윤희 (충남대학교)
왕경석 (헤아림한의원)
조성근 (충남대학교)

초록

통증이 있는 경우, 위협이 되는 자극에 주의를 과도하게 지속하거나 회피하는 것은 통증을 만성화시키는 데 취약성 요인으로 작용할 수 있다. 이 연구는 주의편향 유형이 만성통증 환자의 일일 통증강도와 일상기능의 관계를 차별적으로 조절하는지에 대해 알아보고자 했다. 이에 대전 소재 한의원에서 만성통증 환자 41명을 모집했다. 연구 참여자는 설문지 작성 후, 아이트래커(eye-tracker)를 통해 주의개입-주의이탈 과제를 수행했고, 이후 14일 동안 매일 통증일지를 작성했다. 수집된 데이터를 HLM(Hierarchical Linear Modeling) 통계 프로그램으로 다층분석한 결과, 일일 통증강도와 일일 활동회피, 일일 집중곤란 간 주의편향의 조절효과가 유의했다. 구체적으로, 지속 주의과정에서 통증관련 단어를 느리게 응시하거나 빠르게 이탈할 때, 일일 통증강도가 높을수록 일상에서 활동을 더 많이 회피했다. 또한 통증관련 단어를 중립단어보다 오래 응시할 때, 일일 통증강도가 높을수록 일상에서 집중을 더 어려워했다. 반면, 초기 주의과정에서는 주의편향이 일일 통증강도와 일일 활동회피, 일일 집중곤란 간의 관계를 조절하지 않았다. 이러한 연구 결과는 만성통증 환자의 주의편향과 일일 통증강도, 그리고 일상기능 간의 관계를 보여주며, 만성통증의 예방 및 관리 개입에 대한 방향성을 시사한다.

keywords
만성통증, 주의편향, 주의개입, 주의이탈, 일지연구, chronic pain, attentional biases, engagement, disengagement, diary study

Abstract

Attentional bias is a selective attention to specific information in the environment and can be classified into two types: engagement and disengagement. It has been reported that these two types of attentional bias impact the development and maintenance of chronic pain. The purpose of this study was to investigate if the type of attentional bias in patients with chronic pain has a differential impact on their daily function. We recruited 33 patients with chronic pain in the Oriental medical clinic. The subjects completed a questionnaire and then performed an engagement-disengagement task involving pain-related and neutral word pairs and eye tracker. They completed the online diary for 14 days from the day following the task. The data were analyzed by the HLM statistical program. The results of the analysis showed that when the subjects’ engagement with pain-related words was slow, the greater the intensity of pain, the greater the avoidance of daily activities. Also, when the subjects’ disengagement from pain-related words was rapid, the greater the intensity of pain, the greater the avoidance of daily activities. Additionally, when the subjects’ attentional maintenance in pain-related words was longer than in the neutral words, the greater the intensity of pain, the greater the distractibility of daily activities. This study revealed that the type of attentional bias in chronic pain patients has different impacts on their daily function. These findings suggest that patients with chronic pain who slowly engage with or quickly disengage from pain-related words may have difficulties in different areas of their daily function.

keywords
만성통증, 주의편향, 주의개입, 주의이탈, 일지연구, chronic pain, attentional biases, engagement, disengagement, diary study

참고문헌

1.

김민재, 강수경, 전양현, 홍정표, 어규식 (2013). 하행성조절계 : 만성 통증에 대한 제어 작용. Journal of Oral Medicine and Pain, 38(2), 215-219.

2.

오세만, 민경준, 박두병 (1999). 병원 불안-우울 척도에관한 표준화 연구. 대한신경정신의학학회지, 38(2), 289-296.

3.

장승민 (2011). 일기법을 이용한 심리학 연구의 최근 동향과 전망. 한국심리학회지: 일반, 30(3), 677-706.

4.

정태진, 조성근 (2020). 통증위협 상황에서 반추유형에따른 주의편향과 회피행동. 한국심리학회지: 건강, 25(1), 225-241.

5.

진병주, 조성근 (2018). 통증위협과 주의편향 간의 관계에서 자아고갈이 미치는 조절효과. 한국심리학회지:건강, 23(4), 963-979.

6.

Asmundson, G. J., Kuperos, J. L., & Norton, G. R. (1997). Do patients with chronic pain selectively attend to pain-related information?: preliminary evidence for the mediating role of fear. Pain, 72(1-2), 27-32.

7.

Baum, C., Schneider, R., Keogh, E., & Lautenbacher, S. J. (2013). Different stages in attentional processing of facial expressions of pain: a dot-probe task modification. The Journal of Pain, 14(3), 223-232.

8.

Bortz II, W. M. (1984). The disuse syndrome. Western Journal of Medicine, 141(5), 691-694.

9.

Bowler, J. O., Bartholomew, K. J., Kellar, I., Mackintosh, B., Hoppitt, L., & Bayliss, A. P. (2017). Attentional bias modification for acute experimental pain: A randomized controlled trial of retraining early versus later attention on pain severity, threshold and tolerance. European Journal of Pain, 21(1), 112-124.

10.

Bradley, B. P., Mogg, K., & Lee, S. C. (1997). Attentional biases for negative information in induced and naturally occurring dysphoria. Behaviour Research and Therapy, 35(10), 911-927.

11.

Brookes, M. L., Sharpe, L., & Dear, B. F. (2017). Rumination induces a pattern of attention characterized by increased vigilance followed by avoidance of affective pain words. European Journal of Pain, 21(7), 1197-1208.

12.

Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W., & Karoly, P. (2012). Fear-avoidance model of chronic pain: the next generation. The Clinical Journal of Pain, 28(6), 475-483.

13.

Crombez, G., Van Damme, S., & Eccleston, C. (2005). Hypervigilance to pain: an experimental and clinical analysis. Pain, 116(1), 4-7.

14.

Crombez, G., Van Ryckeghem, D. M., Eccleston, C., & Van Damme, S. (2013). Attentional bias to pain-related information: a meta-analysis. Pain, 154(4), 497-510.

15.

Crombez, G., Vervaet, L., Lysens, R., Baeyens, F., &Eelen, P. (1998). Avoidance and confrontation of painful, back-straining movements in chronic back pain patients. Behavior Modification, 22(1), 62-77.

16.

Donaldson, C., Lam, D., & Mathews, A. (2007). Rumination and attention in major depression. Behaviour Research and Therapy, 45(11), 2664-2678.

17.

Eccleston, C., & Crombez, G. (1999). Pain demands attention: A cognitive–affective model of the interruptive function of pain. Psychological Bulletin, 125(3), 356-366.

18.

Fashler, S. R., & Katz, J. (2014). More than meets the eye: visual attention biases in individuals reporting chronic pain. Journal of Pain Research, 7, 557-570.

19.

Fashler, S. R., & Katz, J. (2016). Keeping an eye on pain: Investigating visual attention biases in individuals with chronic pain using eye-tracking methodology. Journal of Pain Research, 9, 551-561.

20.

Jamison, R. N., Raymond, S. A., Levine, J. G., Slawsby, E. A., Nedeljkovic, S. S., & Katz, N. P. (2001). Electronic diaries for monitoring chronic pain: 1-year validation study. Pain, 91(3), 277-285.

21.

Jamison, R. N., Sbrocco, T., & Parris, W. C. (1989). The influence of problems with concentration and memory on emotional distress and daily activities in chronic pain patients. The International Journal of Psychiatry in Medicine, 18(2), 183-191.

22.

Keogh, E., Ellery, D., Hunt, C., & Hannent, I. (2001). Selective attentional bias for pain-related stimuli amongst pain fearful individuals. Pain, 91(1-2), 91-100.

23.

Khatibi, A., Dehghani, M., Sharpe, L., Asmundson, G. J., & Pouretemad, H. (2009). Selective attention towards painful faces among chronic pain patients: evidence from a modified version of the dot-probe. Pain, 142(1-2), 42-47.

24.

Leeuw, M., Goossens, M. E., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. (2007). The fear-avoidance model of musculoskeletal pain:current state of scientific evidence. Journal of Behavioral Medicine, 30(1), 77-94.

25.

Lewandowski, A. S., Palermo, T. M., Kirchner, H. L., & Drotar, D. (2009). Comparing diary and retrospective reports of pain and activity restriction in children and adolescents with chronic pain conditions. The Clinical Journal of Pain, 25(4), 299-306.

26.

Linton, S. J. (1985). The relationship between activity and chronic back pain. Pain, 21(3), 289-294.

27.

Liossi, C., Schoth, D. E., Bradley, B. P., & Mogg, K. (2009). Time‐course of attentional bias for pain ‐related cues in chronic daily headache sufferers. European Journal of Pain, 13(9), 963-969.

28.

Liossi, C., Schoth, D. E., Godwin, H. J., &Liversedge, S. P. (2014). Using eye movements to investigate selective attention in chronic daily headache. PAIN®, 155(3), 503-510.

29.

Liossi, C., White, P., & Schoth, D. E. (2011). Timecourse of attentional bias for threat‐related cues in patients with chronic daily headache–tension type: Evidence for the role of anger. European Journal of Pain, 15(1), 92-98.

30.

Merskey, H. (2000). Pain, psychogenesis, and psychiatric diagnosis. International Review of Psychiatry, International Review of Psychiatry, 12(2), 99-102.

31.

Merskey, H. (1991). The definition of pain. European Psychiatry, 6(4), 153-159.

32.

Öhman, A. (1996). Preferential preattentive processing of threat in anxiety: Preparedness and attentional biases. Current Controversies in the Anxiety Disorders, 2, 253-290.

33.

Palermo, T. M., & Valenzuela, D. (2003). Use of pain diaries to assess recurrent and chronic pain in children. Suffer Child, 3, 1-19.

34.

Pincus, T., & Morley, S. (2001). Cognitive-processing bias in chronic pain: a review and integration. Psychological Bulletin, 127(5), 599-617.

35.

Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Applications and data analysis methods (Vol. 1). CA: Sage Publications.

36.

Rost, S., Van Ryckeghem, D. M., Koval, P., Sütterlin, S., Vögele, C., & Crombez, G. (2016). Affective instability in patients with chronic pain: a diary approach. Pain, 157(8), 1783-1790.

37.

Sanchez, A., Vazquez, C., Marker, C., LeMoult, J., &Joormann, J. (2013). Attentional disengagement predicts stress recovery in depression: An eye-tracking study. Journal of Abnormal Psychology, 122(2), 303-313.

38.

Schoth, D. E., & Liossi, C. (2010). Attentional bias toward pictorial representations of pain in individuals with chronic headache. The Clinical Journal of Pain, 26(3), 244-250.

39.

Schoth, D. E., Nunes, V. D., & Liossi, C. (2012). Attentional bias towards pain-related information in chronic pain; a meta-analysis of visual-probe investigations. Clinical Psychology Review, 32(1), 13-25.

40.

Sharpe, L. (2012). Attentional biases and their role in the management of pain. Pain, 153(12), 2307-2308.

41.

Sharpe, L., Haggman, S., Nicholas, M., Dear, B. F., &Refshauge, K. (2014). Avoidance of affective pain stimuli predicts chronicity in patients with acute low back pain. PAIN®, 155(1), 45-52.

42.

Sharpe, L., Ianiello, M., Dear, B. F., Perry, K. N., Refshauge, K., & Nicholas, M. K. (2012). Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials. Pain, 153(3), 722-731.

43.

Skinner, I. W., Hübscher, M., Moseley, G. L., Lee, H., Wand, B. M., Traeger, A. C., ... & McAuley, J. H. (2018). The reliability of eyetracking to assess attentional bias to threatening words in healthy individuals. Behavior Research Methods, 50(5), 1778-1792.

44.

Stone, A. A., & Broderick, J. E. (2007). Real‐time data collection for pain: Appraisal and current status. Pain Medicine, 8, S85-S93.

45.

Stone, A. A., Shiffman, S., Schwartz, J. E., Broderick, J. E., & Hufford, M. R. (2003). Patient compliance with paper and electronic diaries. Controlled Clinical Trials, 24(2), 182-199.

46.

Todd, J., Sharpe, L., & Colagiuri, B. (2016). Attentional bias modification and pain: The role of sensory and affective stimuli. Behaviour Research and Therapy, 83, 53-61.

47.

Todd, J., Sharpe, L., Johnson, A., Perry, K. N., Colagiuri, B., & Dear, B. F. (2015). Towards a new model of attentional biases in the development, maintenance, and management of pain. Pain, 156(9), 1589-1600.

48.

Van Ryckeghem, D. M., Crombez, G., Goubert, L., De Houwer, J., Onraedt, T., & Van Damme, S. (2013). The predictive value of attentional bias towards pain-related information in chronic pain patients: a diary study. PAIN®, 154(3), 468-475.

49.

Vervoort, T., Trost, Z., Prkachin, K. M., & Mueller, S. C. (2013). Attentional processing of other’s facial display of pain: an eye tracking study. PAIN®, 154(6), 836-844.

50.

Vlaeyen, J. W., Kole-Snijders, A. M., Boeren, R. G., & Van Eek, H. (1995). Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain, 62(3), 363-372.

51.

Vlaeyen, J. W., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317-332.

52.

Yang, Z., Jackson, T., & Chen, H. (2013). Effects of chronic pain and pain-related fear on orienting and maintenance of attention: An eye movement study. The Journal of Pain, 14(10), 1148-1157.

53.

Yang, Z., Jackson, T., Gao, X., & Chen, H. (2012). Identifying selective visual attention biases related to fear of pain by tracking eye movements within a dot-probe paradigm. PAIN®, 153(8), 1742-1748.

54.

Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370.

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