认知神经科学视角的催眠研究述评

催眠被广泛的应用在临床心理治疗中, 但是, 关于催眠方面的研究却相当匮乏, 而且相当模糊。近年来, 随着fMRI, ERP和PET等技术的引入, 我们对催眠引导和催眠暗示有了更加深入的理解。对于疼痛和幻觉的研究表明, 至少对于高暗示性被试而言, 催眠暗示可以引起与真实刺激同样的大脑皮层的激活; 而催眠后暗示对于注意策略的调控, 可以使原有的认知过程发生改变, 其中之一是使用催眠后暗示来抑制“Stroop效应”语义加工过程; 催眠后遗忘更是实现了内隐记忆和外显记忆遗忘的分离。未来研究者将继续从探讨催眠本身的神经属性和催眠暗示所引起的认知过程的改变两个角度去认识催眠, 揭开催眠的实质。     

脑功能成像在催眠状态中的研究进展

催眠是一种特殊的意识状态。本文从意识状态、疼痛及精神病理现象三个方面对脑功能成像在催眠状态中的研究进展进行了回顾,并对脑功能成像技术进行了比较。提出国内可以借鉴相应的方法来研究中国气功。     

Hypnosis and belief: A review of hypnotic delusions

Hypnosis can create temporary, but highly compelling alterations in belief. As such, it can be used to model many aspects of clinical delusions in the laboratory. This approach allows researchers to recreate features of delusions on demand and examine underlying processes with a high level of experimental control. This paper reviews studies that have used hypnosis to model delusions in this way. First, the paper reviews studies that have focused on reproducing the surface features of delusions, such as their high levels of subjective conviction and strong resistance to counter-evidence. Second, the paper reviews studies that have focused on modelling underlying processes of delusions, including anomalous experiences or cognitive deficits that underpin specific delusional beliefs. Finally, the paper evaluates this body of research as a whole. The paper discusses advantages and limitations of using hypnotic models to study delusions and suggests some directions for future research.     

癌症疼痛心理社会干预治疗的研究进展

癌症疼痛是一种复杂和多维的感受,与心理和社会因素相互影响。本文回顾近期国内外相关研究指出,许多重要的社会心理因素与疼痛有关,包括心理压力、应对方法、社会支持以及社会经济因素,它们是疼痛管理的难点。近期的国内外研究表明缓解癌痛的心理社会干预措施包括：疼痛教育、应对技能训练和催眠等,它们对疼痛治疗管理是有益的补充,同时抗抑郁药物应用对疼痛治疗有益。     

The moral power of suggestion: A history of suggestion in Japan, 1900–1930

In Japan, as in the west, suggestion theory was the predominant theory of hypnosis, and suggestive therapy was one of the most important, if not the most important, form of psychotherapy in the early 20th century. While the use of suggestion was met with objections on both scientific and moral grounds in the west, it was seen in a more positive light and has had a significant influence on the development of psychotherapy in Japan. With regard to the contexts of suggestion, suggestive power, suggestibility, and the effects of suggestion, this study will examine the distinctive conceptions and practices of suggestion developed by analogy with existing ideas about interpersonal influence, particularly with the concept of kanka (assimilative transformation) in Japan. They provide an interesting comparison to the western ideas of suggestion, helping us understand the historical and cultural particularity of western dynamic psychiatry and psychotherapy, particularly their presumptions about interpersonal influence.     

Understanding and Treating Pain in Ethnically Diverse Patients

A revolution has taken place during the past 25 years in the understanding and treatment of chronic pain. Psychologists have contributed tremendously to this revolution. However, the primary psychological models of pain treatment have failed to adequately integrate the empirical findings and theoretical understanding of the role of ethnic factors. The goal of this paper is to address this problem by demonstrating the importance of understanding ethnic factors in treating pain, providing an overview of ethnic factors in pain, and proposing guidelines for Clinical Psychologists who treat pain patients from ethnically diverse backgrounds.     

The Neurobiological Underpinnings of Coping With Pain

ABSTRACT— The biopsychosocial model treats pain as resulting from a complex interaction of biological, psychological, and social factors. Individual differences in approaches to coping with pain-related symptoms are important determinants of pain-related outcomes, and are often classified under the "psychological" category within the biopsychosocial model. However, engagement in various cognitive, affective, and behavioral pain-coping strategies appears to exert biological effects, which we review here. Pain-coping activities such as catastrophizing, distracting oneself from pain sensations, or reappraisal of pain may exert effects on activity in a variety of pain-processing and pain-modulatory circuits within the brain, as well affect the functioning of neuromuscular, immune, and neuroendocrine systems. The interface between pain-related neurobiology and the use of specific pain-coping techniques represents an important avenue for future pain research.     

老年慢性疼痛患者疼痛接受与疼痛程度的相关关系

了解老年慢性疼痛患者疼痛接受与疼痛程度,探讨两者的相关关系.采用简易慢性疼痛接受问卷（CPAQ-8）中文版、简化McGill疼痛问卷（SF-MPQ）与一般情况调查表对335例老年疼痛患者进行调查.结果纳入有效样本308例,SF-MPQ总体平均分为（50.24±23.35）分,中文版CPAQ-8总体平均得分（21.74±5.97）分.老年慢性疼痛患者的受教育程度、疼痛期、疼痛部位及疼痛点数目等差异有统计学意义（P＜0.05）.疼痛接受与疼痛程度呈负相关（P＜0.01）,即接受程度越高者,其疼痛程度越低.     

催眠定义探新：以恍惚为特色的深度沟通

综述催眠发展史上主要催眠观点,归纳其激活、意境、灵活、具身及整合等基本特征,继而提出催眠是一种以恍惚为特色的深度沟通的新定义,认为催眠本质上是一种沟通,恍惚是其特色,深度与恍惚相结合有助于界定催眠。未来应加强与认知神经科学、精神分析以及中国传统文化等的融合研究。     

Myths and misconceptions about hypnosis and suggestion: Separating fact and fiction

We present 21 prominent myths and misconceptions about hypnosis in order to promulgate accurate information and to highlight questions for future research. We argue that these myths and misconceptions have (a) fostered a skewed and stereotyped view of hypnosis among the lay public, (b) discouraged participant involvement in potentially helpful hypnotic interventions, and (c) impeded the exploration and application of hypnosis in scientific and practitioner communities. Myths reviewed span the view that hypnosis produces a trance or special state of consciousness and allied myths on topics related to hypnotic interventions; hypnotic responsiveness and the modification of hypnotic suggestibility; inducing hypnosis; and hypnosis and memory, awareness, and the experience of nonvolition. By demarcating myth from mystery and fact from fiction, and by highlighting what is known as well as what remains to be discovered, the science and practice of hypnosis can be advanced and grounded on a firmer empirical footing.     

The Social Pain Posit

Although discussion of social pain has become popular among researchers in psychology and behavioural neuroscience, the philosophical community has yet to pay it any direct attention. Social pain is characterized as the emotional reaction to the perception of the loss or devaluation of desired relationships. These are argued to comprise a pain type and are explicitly intended to include the everyday sub-types grief, jealousy, heartbreak, rejection, and hurt feelings. Social pain is accordingly posited as a nested type of pain encompassing multiple emotional sub-types. Call this the social pain posit. This article focuses on whether we should endorse the social pain posit and, in particular, whether social pain is pain. I present the four lines of evidence for the social pain posit that are currently offered in the literature and I argue that each provides only inadequate support, taken either individually or together. I close by considering the significance of the presented argument for philosophical theorizing about the nature and the moral significance of affective experiences in particular and mental taxonomizing more generally.     

慢性腹痛

慢性腹痛病史较长,性质不定。引起慢性腹痛的原因很多,除器质性疾病外,一些功能性疾病也引起,如最终找不出具体原因,则可称之为功能性腹痛综合征。诊断比较困难,也容易误诊,甚至误治,外科医生应特别慎重。误诊的思维原因包括对引起慢性腹痛的原因认识不全面,思维惰性,辩证思维不周密和思维简化等。     

Pain: Biopsychosocial Mechanisms and Management

Traditionally, pain has been viewed as a sensory event warning of tissue damage or illness. This explanation fails to account for many of the experiences of people suffering from clinically painful conditions. Over the past two decades, a new biopsychosocial perspective on pain has emerged. This perspective emphasizes that pain is a dynamic process that not only is influenced by biological, psychological, and social mechanisms of pain, but also produces biological, psychological, and social changes that can affect future responses to pain. This review presents findings from recent studies of the biological, psychological, and social mechanisms of pain and discusses the implications of these findings for pain research, assessment, prevention, and treatment, as well as for health care policy.     

疼痛恐惧对疼痛的影响及其认知机制

疼痛恐惧是把将要出现的疼痛刺激视为主要威胁而产生的一种恐惧,它会影响与疼痛相关的感知觉、注意、回避行为以及安慰剂止痛的效果.疼痛恐惧的认知模型主要有活动回避模型、恐惧-回避模型以及内感受性恐惧条件模型.未来的研究要进一步探究疼痛恐惧的认知机制,完善疼痛恐惧的认知模型并扩展疼痛恐惧的研究方法.     

Movement Variability Increases With Shoulder Pain When Compensatory Strategies of the Upper Body Are Constrained

This cross-sectional study analyzed the influence of chronic shoulder pain (CSP) on movement variability/kinematics during humeral elevation, with the trunk and elbow motions constrained to avoid compensatory strategies. For this purpose, 37 volunteers with CSP as the injured group (IG) and 58 participants with asymptomatic shoulders as the control group (CG) participated in the study. Maximum humeral elevation (Emax), maximum angular velocity (Velmax), variability of the maximum angle (CVEmax), functional variability (Func_var), and approximate entropy (ApEn) were calculated from the kinematic data. Patients' pain was measured on the visual analogue scale (VAS). Compared with the CG, the IG presented lower Emax and Velmax and higher variability (i.e., CVEmax, Func_var, and ApEn). Moderate correlations were achieved for the VAS score and the kinematic variables Emax, Velmax and variability of curve analysis, Func_varm, and ApEn. No significant correlation was found for CVEmax. In conclusion, CSP results in a decrease of angle and velocity and an increased shoulder movement variability when the neuromuscular system cannot use compensatory strategies to avoid painful positions.     

慢性疼痛与心理障碍

疼痛是一种复杂的心理生物学过程。疼痛的感知和情绪活动密不可分,疼痛是一种包括感觉、情绪和认知的多维性体验,人与人之间差异很大,甚至同一个体也随疼痛的背景、意义以及心理状态而异。认知因素和情感因素对疼痛感知具有非常重要的影响。本文回顾疼痛认知和情感状态调节（身心治疗的重要组成部分）潜在的神经学机制。回顾慢性疼痛本身会改变大脑环路、包括参与内源性疼痛调节的循证证据,这些证据表明随着疼痛转为慢性,控制疼痛越来越困难。     

A Review of Outcome Studies on Cognitive-Behavioral Therapy for Reducing Fear-Avoidance Beliefs Among Individuals With Chronic Pain

In the last two decades, emerging research has focused on advancing the explanations of how chronic pain becomes disabling. The fear-avoidance model of pain suggests that fear of reinjury in chronic pain patients leads to avoidance of certain movements that subsequently results in more pain and disability from that lack of movement. The literature supporting this model of pain and disability has allowed specific therapeutic interventions to be developed aimed at reducing pain-related fears in an attempt to reduce the physical symptoms and disability of chronic pain. Studies using cognitive-behavioral interventions to reduce fear-avoidance beliefs are reviewed and the treatments are evaluated based on the studies’ effectiveness. The author concludes that graded exposure in vivo appears to be the most effective treatment for chronic pain in individuals with increased fear and avoidance.     

治疼必需知痛

疼痛是人体可感知所有伤害性刺激中最难以忍受的恶性刺激,医学范畴下的疼痛是指组织损伤的前提下产生的＂躯体的不愉快的疼感觉＂加上＂与之相匹配的痛苦情感体验＂两方面内容。长期以来我们的医疗行为＂过多关注组织损伤对疼的调控、忽视了痛苦体验的人文关怀＂制约了我们服务层次。新的生物医学模式下诊疗工作强调细化疼痛分类、躯体与心理并重,以专科诊疗思路指导临床,提高医务人员对病痛的理解、引导供需匹配式的人性医疗服务是时代发展务实之举。     

团队合作对4838例居家癌痛患者疼痛管理的效果与思考

通过对大连医科大学附属第一医院宁养院2001年3月～2013年11月收治的4838例癌痛患者进行调查,总结归纳居家癌痛患者的疼痛控制情况,探索癌痛患者的疼痛管理方法,结果提示依靠团队合作在居家条件下免费向癌痛患者及其家属提供身体、心理、社会和精神全方位的照顾和支持,即理想的疼痛管理是“整体性疼痛”与“整体性痛苦”的治疗,不仅针对临床疼痛症状,还必须处理相关因素。     

Psychosocial Subgroups, Coping, and Chronic Low-Back Pain

The purpose of this study was to compare psychosocial subgroups in terms of pain coping strategies, pain severity, physical impairment, pain behavior, affective distress, and response to pain management treatment. The Multidimensional Pain Inventory (MPI) was used to classify 67 chronic low-back pain (CLBP) patients into the following psychosocial subgroups: Dysfunctional, Interpersonally Distressed, Adaptive Coping, and Anomalous. These MPI subgroups were compared on the Pain Behavior Checklist, Behavioral Observation Measure of Pain Behavior, Revised Coping Strategies Questionnaire, and Chronic Disease Index. The Dysfunctional subgroup reported significantly more pain behavior, disability, affective distress, and catastrophizing than either the Interpersonally Distressed subgroup or Adaptive Copers, but were not significantly different on measures of adaptive coping strategies. The percentage of dropouts from treatment was significantly less among Adaptive Copers (11%) than among the Dysfunctional (33%) or Interpersonally Distressed (47%) subgroups. Differences in affective distress found among the MPI subgroups at baseline were not evident at the posttreatment assessment. The present findings support the use of MPI psychosocial subgroup analysis to enhance our understanding of differential response to chronic pain and pain management intervention.