System and method for evaluation and correction of cognitive bias in painTechnical Field
The present invention relates to the technical fields of psychology, neuroscience, medicine and rehabilitation, and more particularly to a system and method for assessing and correcting cognitive bias of pain.
Background
Pain is associated with actual or potential tissue damage, similar unpleasant sensations and emotional experiences, which contain not only sensory-distinguishing components, but also mood-motivating and cognition-evaluating components. Pain cognitive bias is the negative mood titer of an individual's cognitive processing bias on pain-related information (e.g., pain text, picture, or somatic pain experience), including selectively noticing the pain-related information (attention bias), interpreting ambiguous physical sensations or situations as pain (interpretation bias), selectively recall information related to pain (memory bias). In addition to these three cognitive biases, there have also been few studies beginning to focus on unconsciously monitored, automated cognitive biases in chronic pain patients, i.e., implicit bias in pain.
At present, in a broad sense, various efforts are made by researchers in the related field at the individual cognitive function evaluation level, for example, a system and a method for evaluating cognitive ability at the broad sense level are disclosed in Chinese patent application publication No. CN110801237A, which is 2 months in 2020, in which a cognitive experimental scheme is firstly determined, a plurality of experimental devices such as an eye movement acquisition device and an electroencephalogram acquisition device are relied on by utilizing an experimental paradigm, then a cognitive evaluation score is obtained by combining an analysis result of the experimental devices, the cognitive evaluation score is externally displayed, and evaluation is objective, so that the evaluation accuracy of the cognitive ability of the individual in the broad sense is obviously improved.
In particular to the pain cognition level, clinical studies have found that chronic pain patients exhibit a stronger cognitive bias on pain-related information and have a positive correlation with pain and disability levels relative to healthy humans, suggesting that chronic pain patients who suffer from pain for a long period of time tend to be more passive, poorly adapted, and may play a propulsive role in the maintenance and development of chronic pain. Therefore, it is particularly important to accurately evaluate the cognitive processing process of the individual on the pain information, not only can predict the occurrence and development of chronic pain, but also can provide a basis for the chronic pain patients to relieve the pain through cognitive correction, and in addition, clinical researches also find that the chronic pain patients with the pain cognition deviation alertness have poor rehabilitation treatment effect in the subsequent rehabilitation treatment process, so that a mode of further correcting the abnormal pain cognition of the individual on the premise of accurately and systematically evaluating the pain cognition deviation of the individual is studied, and the method has important practical significance for the recovery of the pain patients.
Disclosure of Invention
In order to solve the problem of how to accurately and systematically evaluate the pain cognition bias of an individual and further correct the abnormal pain cognition bias of the individual, the invention provides a pain cognition bias evaluation and correction system and method based on a behavior test, which comprehensively and accurately evaluate the pain cognition bias of the individual and correct and intervene on the individual with the abnormal pain cognition bias so as to improve physical and mental health.
In order to achieve the technical effects, the technical scheme of the invention is as follows:
an assessment and correction system for cognitive bias in pain, comprising:
the system comprises a plurality of behavior testing modules, a pain cognition deviation evaluation module and a pain cognition deviation evaluation module, wherein each behavior testing module is internally provided with a behavior realization task paradigm for each self-supplied subject to conduct behavior test;
the mode selection switching module is used for selecting and switching the sequence of entering a plurality of behavior testing modules according to the actual psychological tendency condition of the subject at the time of evaluation when the pain cognition deviation is evaluated;
the behavior test visual target generation and adjustment module is used for realizing a task paradigm according to the behavior adopted by the behavior test of the subject when the pain cognition deviation is evaluated, and generating and adjusting a behavior test pain clue visual target;
The display module is used for displaying a behavioral test pain cue visual target required by a behavioral test performed by a subject during pain cognitive bias evaluation;
the statistics module is used for recording key responses of the subject under different behavior tests and counting pain cognition deviation behavior indexes of the subject under different behavior tests when evaluating the pain cognition deviation;
the first judging module is used for judging whether the test subject traverses to finish the behavior test of all the behavior testing modules;
the central processing module is used for integrating and analyzing the pain cognition deviation behavior indexes of the subject under different behavior test modules to obtain the overall pain cognition deviation assessment result indexes of the subject;
the second judging module is used for judging whether the pain cognition deviation behavior index of the subject in different behavior tests and the overall pain cognition deviation index of the subject are in a set normal range or not;
and the correction module is used for performing anodic stimulation on the dorsally-lateral forehead cortex of the subject by adopting repetitive transcranial direct current stimulation when the pain cognition deviation behavior index of the subject under different behavior tests and the overall pain cognition deviation assessment result index of the subject exceed the normal range, so that the pain cognition deviation of the subject is corrected.
In the technical scheme, the evaluation side is carried out through the plurality of behavior test modules, pain cognition deviation index data of a subject is obtained, the pain cognition deviation index data is compared with sample library data, whether the cognition deviation index of the subject is in a set normal range is judged, if the cognition deviation index is out of the normal range, the correction module intervenes, so that the cognition deviation of the subject returns to a normal level, and the physical and mental health is improved.
Preferably, the plurality of behavior test modules include: the device comprises a pain attention deviation behavior testing module, a pain interpretation deviation behavior testing module, a pain memory deviation behavior testing module and a pain implicit deviation behavior testing module;
the pain attention deviation behavior test module is internally packaged with a pain attention deviation behavior test program for loading a pain attention deviation behavior test, and the pain attention deviation behavior test is realized based on a point detection task paradigm;
the pain interpretation deviation behavior test module is internally packaged with a pain interpretation deviation behavior test program for loading a pain interpretation deviation behavior test, and the pain interpretation deviation behavior test is realized based on an attached learning task paradigm;
the pain memory deflection behavior test module is internally packaged with a pain memory deflection behavior test program for loading a pain memory deflection behavior test, and the pain memory deflection behavior test is realized based on a picture recall task paradigm;
The pain implicit negative bias behavior test module is internally packaged with a pain implicit negative bias behavior test program for loading a pain implicit negative bias behavior test, and the pain implicit negative bias behavior test is realized based on an implicit associativity test task paradigm.
Here, the cognitive bias of the subject on the pain-related information is assessed by the behaviometrical measurement method from four aspects of attention, explanation, memory and implicit attitude; attention to pain is biased to selectively prioritize the notice of pain-related information, interpretation of pain is biased to interpret ambiguous physical sensations or situations as pain, and memory of pain is biased to recall more of the memory associated with pain; the implicit deviation of the pain is achieved by automatically linking the pain with the negative potency attribute, representing the implicit negative deviation of the pain, and loading the four behavior test modules together to more comprehensively evaluate the attention, interpretation and memory deviation of the individual on the pain related information.
Preferably, the pain attention deviation behavior testing module, the pain interpretation deviation behavior testing module, the pain memory deviation behavior testing module and the pain implicit deviation behavior testing module are all connected with the mode selection switching module; the mode selection switching module is provided with characteristic labels which respectively represent specific test attributes of the pain attention deviation behavior test module, the pain interpretation deviation behavior test module, the pain memory deviation behavior test module and the pain implicit deviation behavior test module, when the pain cognition deviation is evaluated, a subject generates psychological tendency selection according to the observed characteristic labels at the evaluation moment, determines the sequence of entering a plurality of behavior test modules, and starts to evaluate the pain cognition deviation based on different behavior tests.
Preferably, when the subject enters the pain attention deviation behavior test module to perform the pain attention deviation behavior test, the behavior test visual target generation adjustment module generates a "pain+neutral" word visual target, a "gaze point" visual target, a "neutral+neutral" word visual target and a "target stimulus" visual target, adjusts the maintenance time of the "pain+neutral" word visual target, the "gaze point" visual target, the "neutral+neutral" word visual target and the "target stimulus" visual target, the subject makes a key response, and evaluates the attention deviation condition of the subject to the behavior test pain cue visual target;
when a subject enters a pain interpretation bias behavior test, the behavior test visual target generation adjustment module generates a 'gaze point' visual target, a 'happy face' visual target, a 'pain face' visual target, a 'fuzzy face' visual target and a 'target stimulation' visual target, adjusts the maintenance time of the 'gaze point' visual target, the 'happy face' visual target, the 'pain face' visual target, the 'fuzzy face' visual target and the 'target stimulation' visual target, learns the prediction rule of the appearance positions of the 'happy face' and the 'pain face' to the 'target stimulation' in a learning stage, and in a test stage, the subject makes a key reaction to the 'target stimulation' after the 'fuzzy face' visual target, and evaluates the deviation degree of the 'fuzzy face' visual target interpreted as pain information by the subject;
When a subject enters a pain memory deflection behavior test, the behavior test visual target generation and adjustment module generates a 'gaze point' visual target, a 'pain' picture and a 'non-pain' picture, and adjusts the maintenance time of the 'gaze point' visual target, the 'pain' picture and the 'non-pain' picture, the subject memorizes the 'pain' picture and the 'non-pain' picture, then enters a 'pain' picture and a 'non-pain' picture reconfirming stage, a key reaction is made, the recall accuracy of the 'pain' picture and the 'non-pain' picture is recorded, and the memory deflection degree of the subject to pain information is evaluated according to the difference of the recall accuracy;
when a subject enters a pain implicit negative bias behavior test, the behavior test visual target generation and adjustment module generates a pain word visual target, a non-pain word visual target, a negative emotion word visual target, a neutral emotion word visual target, and a negative emotion word visual target, wherein the negative emotion word visual target is introduced into an implicit association test task model, so that 3 parts which are matched with the display test are formed between the pain word visual target, the non-pain word visual target, the negative emotion word visual target and the neutral emotion word visual target for classifying the subject and performing key reaction to form an implicit association test task model, and the connection strength of the pain and the negative emotion, namely the pain implicit negative bias of the subject at the implicit level is evaluated; the 3 parts for the fit display test include: in the practice section, the subject distinguishes between "painful" and "non-painful" targets, and between "negative and" neutral "targets; in the compatibility condition part, matching the 'painful words' optotypes with the 'negative emotion words' optotypes and assigning the same key, matching the 'non-painful words' optotypes with the 'neutral emotion words' optotypes and assigning the same key, and requiring the subject to perform key reaction on the presented words according to the matching rule; in the non-compatible condition part, matching the 'painful word' visual target with the 'neutral emotion word' visual target and assigning the same key, and matching the 'non-painful word' visual target with the 'negative emotion word' visual target and assigning the same key, so that the subject is required to perform key reaction on the presented words according to the matching rule; the implicit negative bias of the subject on pain information is assessed by comparing key responses under compatible and incompatible conditions.
The attention deviation characteristics of the subjects to the pain information are respectively depicted from the point detection task paradigm; the method comprises the steps of describing the interpretation bias characteristics of pain information of a subject from an accessory learning task paradigm, describing the memory bias characteristics of the pain information of the subject from a picture recall task paradigm, describing the implicit negative attitude of the pain information of the subject by adopting an implicit association test task optimization paradigm so as to realize multidimensional pain cognition evaluation, wherein the pain cognition evaluation is carried out by dividing each object on the surface, but from the system perspective, the combination of four modules is involved, and the integration level is higher.
Preferably, the system further comprises:
the acquisition and presetting module is used for acquiring pain cognition deviation behavior index data of N individuals under different behavior tests and pain cognition deviation assessment result index data of N individual populations in advance, wherein N is a positive number capable of representing the current situation of universality, the pain cognition deviation behavior index data of N individuals under different behavior tests and the pain cognition deviation assessment result index data of N individual populations are respectively subjected to normal distribution, and the negative standard deviation-sigma of each is takenj And positive standard deviation +sigmaj Composition interval (-sigma)j ，+σj ) As a normal range in which the pain cognitive bias is set, if the pain cognitive bias exceeds the normal range, the abnormality is judged, j represents the order of the pain cognitive bias behavior indexes, and represents the pain cognitive bias behavior indexes of N individuals under different behavior tests and the pain cognitive bias of the N individuals as a whole Evaluating one of the outcome indicators;
when the pain cognition deviation behavior index of the subject under different behavior tests and the overall pain cognition deviation assessment result index of the subject correspond to the interval (-sigma)j ，+σj ) In the internal time, the pain cognition of the subject is biased to be normal and does not need correction; when the pain cognition deviation behavior index of the subject under different behavior tests and the overall pain cognition deviation assessment result index of the subject exceed the interval (-sigma)j ，+σj ) When the pain cognition bias of the subject exceeds the set normal range, the correction is needed;
when the pain cognitive deviation of the subject exceeds a set normal range, the correction module carries out anodic stimulation on the dorsolateral forehead cortex of the subject by using transcranial direct current stimulation, the stimulation period is two weeks, the frequency is once daily, each time lasts for 20 minutes, and each time lasts for no more than 20 minutes.
Here, comprehensively and comprehensively evaluating pain bias cognition is a precondition of clinical intervention on the pain recovery progress of chronic pain patients, a single pain cognition is probably not representative, and the logical integration of evaluation and correction is a great breakthrough in the field on the pain intervention level.
The invention also provides a pain cognition deviation evaluation correction method based on a behavior test, which is realized based on the pain cognition deviation evaluation correction system and comprises the following steps:
S1, selecting and switching the sequence of entering a plurality of behavior test modules by a mode selection switching module according to the actual psychological tendency condition of the subject at the pain cognition deviation evaluation moment;
s2, determining a first behavior test module selected by a subject, entering the first behavior test module, and starting pain cognition bias evaluation based on the behavior test of the module;
s3, generating and adjusting a behavioral test visual target by a behavioral test visual target generation and adjustment module according to the behavioral test performed by the subject;
s4, displaying a behavioral test pain cue visual target required by the behavioral test of the subject through a display module, observing the behavioral test pain cue visual target by the subject, and performing key-press reaction under a task paradigm in the behavioral test;
s5, recording key response of the subject under the behavior test by using a statistics module, and counting pain cognition deviation behavior indexes of the subject under different behavior tests;
s6, judging whether the test subject has traversed to finish the behavior test of all the behavior test modules by using the first judging module, if so, executing the step S7; otherwise, entering the next behavior testing module according to the sequence of entering a plurality of behavior testing modules in the step S1, starting pain cognition deviation assessment based on the behavior testing of the module, and returning to the step S3;
S7, integrating and analyzing pain cognition deviation behavior data of the subject under different behavior tests through a central processing module to obtain a pain cognition deviation assessment result index of the overall subject, and executing a step S8;
s8, judging whether the pain cognition deviation behavior indexes of the subject and the overall pain cognition deviation assessment result indexes of the subject under different behavior tests are in a set normal range or not through a second judging module, if so, storing the pain cognition deviation behavior indexes of the subject under different behavior tests and the overall pain cognition deviation assessment result indexes of the subject without correction treatment; otherwise, anodal stimulation of the dorsolateral prefrontal cortex of the subject with repeated transcranial direct current stimulation is performed by the correction module to help correct excessive pain cognitive bias.
Preferably, the plurality of behavioral testing modules in step S1 include a pain attention deviation behavioral testing module, a pain interpretation deviation behavioral testing module, a pain memory deviation behavioral testing module and a pain implicit deviation behavioral testing module, and when the pain cognition deviation is evaluated, the mode selection switching module is provided with feature labels for respectively representing specific testing attributes of the pain attention deviation behavioral testing module, the pain interpretation deviation behavioral testing module, the pain memory deviation behavioral testing module and the pain implicit deviation behavioral testing module, and the test subject generates psychological tendency selection according to the feature labels observed by the test subject at the evaluation moment, determines the sequence of entering the plurality of behavioral testing modules, and starts to evaluate different pain cognition deviations based on behavioral tests.
Preferably, the statistics of the pain cognition deviation behavior indexes of the subject under the task paradigm in different behavior tests in step S5 include: attention to the directional acceleration index y1 Difficulty in paying attention to index y2 Deviation index y of pain interpretation3 Memory bias index y for pain4 Implicit deviation index y of pain5 ；
The attention oriented acceleration index y1 Expressed as:
y1 ＝RTneu -RTcong
attention release difficulty index y2 Expressed as:
y2 ＝RTIncong -RTneu
wherein RTneu Indicating that the subject is not noticing the correct average response of the key responses of the allocation test times; RT (reverse transcription) methodcong Indicating that the subject is in a consistent test time when the key response is correct; RT (reverse transcription) methodIncong Indicating that the subject is in a non-uniform test time when the key response is correct; the non-attention allocation test time represents the evaluation test time of the appearance of the neutral and neutral word targets, the consistency test time represents the evaluation test time of the appearance of the target stimulation targets at the same side position of the pain, and the non-consistency test time represents the evaluation test time of the appearance of the target stimulation targets at the opposite side position of the pain; if y1 > 0, indicating that the subject responds faster to the target stimulus at the predicted location of pain, with a marked acceleration of attention; if y2 > 0, indicating that the subject responded more slowly to the contralateral site of pain, indicating that the subject had difficulty in resolving attention.
The pain interpretation bias index y3 Expressed as:
y3 ＝RThappy -RTpain
wherein RThappy And RTpain All represent the subject's response to "target stimulus" following "blurred face" during the test phase, RThappy Is the position of the target stimulus predicted by the "happy face" target in the learning phase, RTpain Is the position of the target stimulus predicted by the "pain face" optotype in which the "target stimulus" optotype appears in the learning phase; if y3 > 0, indicating that the subject can easily interpret "blurred faces" as "painful faces", and that the subject has a bias in pain interpretation;
pain memory deflection index y4 Expressed as:
y4 ＝ACCpain -ACCneu
wherein ACCpain Indicating the recall correctness of the subject to the "pain" picture, ACCneu Indicating the recall correctness of the subject for the "non-painful" picture, if y4 > 0, indicating that the subject has better memory effect on pain pictures, i.e., the subject has pain memory bias;
implicit deviation index y of pain5 Expressed as:
wherein M isincong Average key reaction of the subject under incompatible conditions; m is Mcong Mean key response of subjects under compatible conditions is indicated, SDincong，cong Combining standard deviation for compatible and incompatible test runs; if y5 > 0, indicating that the subject has a tighter linkage to the pain-negative mood word, with a bias in pain incapacitation;
The expression of the overall pain cognitive bias assessment result index of the subject obtained in the step S7 is as follows:
wherein i represents the attention directed acceleration index y1 Difficulty in paying attention to index y2 Deviation index y of pain interpretation3 Memory bias index y for pain4 Implicit deviation index y of pain5 Any one of the sequences; y isi Indicating the attention-directed acceleration index y1 Difficulty in paying attention to index y2 Deviation index y of pain interpretation3 Memory bias index y for pain4 Implicit deviation index y of pain5 N represents the number of indices.
In the method, attention, explanation, memory and implicit deviation of pain related information of a subject are evaluated as starting points, different cognitive deviation behavior data indexes of the subject are introduced, cognitive deviation characteristics of different dimensions are integrated, and finally, an integral pain cognitive deviation evaluation result index is constructed, so that comprehensive evaluation is realized, and a reliable foundation is laid for subsequent further correction work.
Preferably, the process of setting the standard in step S8 is:
the method comprises the steps of collecting pain cognition deviation behavior index data of N individuals under different behavior tests and pain cognition deviation assessment result index data of N individual populations in advance, wherein N is a positive number capable of representing the current situation of universality, respectively making positive distribution of the pain cognition deviation behavior index data of N individuals under different behavior tests and the pain cognition deviation assessment result index data of N individual populations, and taking respective negative standard deviation-sigmaj And positive standard deviation +sigmaj Composition interval (-sigma)j ，+σj ) As a normal range in which the pain cognitive bias is set, if the pain cognitive bias exceeds the normal range, it is determined that the pain cognitive bias is abnormal, j represents the order of the pain cognitive bias behavior indexes, and represents one of the pain cognitive bias behavior indexes of N individuals under different behavior tests and the pain cognitive bias evaluation result indexes of the N individuals as a whole.
Preferably, the pain cognitive bias assessment correction method based on the behavior test further comprises the following steps:
after the correction by the correction module is finished, returning to the step S1 to start pain cognition deviation assessment again until the pain cognition deviation behavior index and the overall pain cognition deviation assessment result index of the subject under different behavior tests are positioned in the normal range of cognition deviation, and performing no correction treatment.
The method is characterized in that the evaluation and correction are matched, the multi-dimensional comprehensive evaluation is taken as a basis, the setting standard of correction is introduced, the correction is carried out on the premise of the evaluation result, the effectiveness of the whole system is further verified through the evaluation after the correction, the double matching is ensured, the individual pain cognition bias is comprehensively and accurately evaluated, the individual abnormal pain cognition bias is corrected, a potential target point is provided for the intervention of clinical pain, and the recovery treatment speed of the subsequent chronic pain patients is facilitated.
The invention has the following beneficial effects:
the invention provides an evaluation and correction system and method for pain cognition deflection, which are characterized in that a plurality of behavior test modules are introduced for pain cognition deflection evaluation, each behavior test module is internally provided with a behavior realization task paradigm for each self-supplied subject to conduct behavior test, and the cognition deflection of the subject to the pain is evaluated from different behavior test aspects through a behavior method, so that the proposed system can evaluate the deflection of the subject to the pain related information more comprehensively, then the pain cognition deflection behavior data of the subject under the optimization of different behavior tests and behavior realization task paradigms are counted, finally the pain cognition deflection data are integrated into the overall pain cognition deflection evaluation result of the subject, the normal range of the pain cognition deflection is introduced, whether the pain cognition deflection index of the subject is located in the normal range is judged, if the pain cognition deflection index exceeds the normal range, the correction module is started to intervene until the pain cognition deflection of the subject returns to the normal range, thereby helping to relieve the pain, improving the physical and mental health of the individual, and having important practical instruction significance for the recovery of the pain patient.
Drawings
FIG. 1 is a schematic diagram showing the structure of a system for evaluating and correcting cognitive bias of pain according to example 1 of the present invention;
FIG. 2 is a schematic diagram showing a model of the implementation of a behavior task when a subject enters the pain attention deflection behavior test module to perform a pain attention deflection behavior test according to the embodiment 1 of the present invention;
FIG. 3 is a schematic diagram showing specific characterizations of "blurred faces", "happy faces" and "painful faces" involved in the performance of the task performance paradigm of the subject as the subject enters the pain interpretation bias behavior test module for pain interpretation bias behavior test, as set forth in example 1 of the present invention;
FIG. 4 is a schematic diagram showing the process of the implementation paradigm of the behavior task when the subject enters the pain interpretation bias behavior test module to perform the pain interpretation bias behavior test according to the embodiment 1 of the present invention;
FIG. 5 is a schematic diagram showing specific pictures that can be characterized by "pain" pictures and "non-pain" pictures when a subject enters the pain memory bias behavior test according to example 1 of the present invention;
FIG. 6 is a schematic diagram showing the process of the model of the implementation of the behavior task when the subject enters the pain memory bias behavior test module to perform the pain memory bias behavior test according to the embodiment 1 of the present invention;
FIG. 7 is a schematic diagram showing the process of the implementation paradigm of the behavior task when the subject enters the implicit negative bias behavior test module to perform the implicit negative bias behavior test in accordance with the embodiment 1 of the present invention;
Fig. 8 is a flow chart of a pain cognition bias evaluation and correction method based on behavioral tests according to embodiment 2 of the present invention.
Detailed Description
The embodiments of the invention will be described in detail below with reference to the attached drawings, but the invention can be implemented in a number of different ways defined and covered by the following description;
example 1
As shown in fig. 1, the present invention proposes an evaluation and correction system for cognitive bias of pain, comprising:
the system comprises a plurality of behavior testing modules, a pain cognition deviation evaluation module and a pain cognition deviation evaluation module, wherein each behavior testing module is internally provided with a behavior realization task paradigm for each self-supplied subject to conduct behavior test; in this embodiment, referring to fig. 1, the number of behavior test modules is 4, and the behavior test modules are respectively: the pain attention deviation behavior test module, the pain interpretation deviation behavior test module, the pain memory deviation behavior test module and the pain implicit deviation behavior test module measure the cognitive deviation of a subject on pain related information from four aspects of attention, interpretation, memory and implicit attitude through a behavior method. Wherein,,
(1) The pain attention deviation behavior test module is internally packaged with a pain attention deviation behavior test program, and is used for loading a pain attention deviation behavior test, wherein the pain attention deviation is information related to the selective preferential attention of pain; pain attention deviation behavior test is realized based on a point detection task paradigm;
(2) The pain interpretation deflection behavior test module is internally packaged with a pain interpretation deflection behavior test program, and is used for loading a pain interpretation deflection behavior test, wherein the pain interpretation deflection is to interpret ambiguous physical feeling or situation as pain; the pain interpretation bias behavior test is realized based on a learning task paradigm;
(3) The pain memory deflection behavior test module is internally packaged with a pain memory deflection behavior test program, and is used for loading a pain memory deflection behavior test, and memorizing the memory related to the pain for the memory deflection of the pain; the pain memory deflection behavior test is realized based on a picture recall task paradigm;
(4) The pain implicit negative bias behavior test module is internally packaged with a pain implicit negative bias behavior test program and is used for loading a pain implicit negative bias behavior test, wherein the implicit bias on the pain is realized by automatically linking the pain with the negative potency attribute and is expressed as the pain implicit negative bias, and the pain implicit negative bias behavior test is realized based on an implicit associativity test task paradigm.
The mode selection switching module is used for selecting and switching the sequence of entering a plurality of behavior testing modules according to the actual psychological tendency condition of the subject at the time of evaluation when the pain cognition deviation is evaluated;
In this embodiment, as shown in fig. 1, the pain attention deviation behavior test module, the pain interpretation deviation behavior test module, the pain memory deviation behavior test module and the pain implicit deviation behavior test module are all connected with the mode selection switching module; in actual implementation, the mode selection switching module is provided with characteristic labels which respectively represent specific test attributes of the pain attention deviation behavior test module, the pain interpretation deviation behavior test module, the pain memory deviation behavior test module and the pain implicit deviation behavior test module, when the pain cognition deviation is evaluated, a subject determines the sequence of entering a plurality of behavior test modules according to the selection of psychological trends generated by the observed characteristic labels at the evaluation moment, and starts to evaluate different pain cognition deviation based on the behavior tests. As a specific implementation manner, in this embodiment, the basic information of the name, sex, age, etc. of the subject that first participates in the correction of the cognitive assessment of pain is collected, and for one of the subjects a, it is selected according to its psychological tendency, first selects "pain attention bias behavior test module" to start behavior test; secondly, selecting a pain interpretation bias behavior test module to start behavior test; then, selecting a 'pain memory bias behavior test module' to start behavior test; finally, selecting a 'pain implicit negative bias behavior test module' to start behavior test.
The behavioral test visual target generation and adjustment module is used for generating and adjusting behavioral test pain cue visual targets according to behavioral tests performed by the subjects during pain cognition deviation evaluation;
the display module is used for displaying a behavioral test pain cue visual target required by a behavioral test performed by a subject during pain cognitive bias evaluation;
the statistics module is used for recording key responses of the subject under different behavior tests and counting pain cognition deviation behavior indexes of the subject under different behavior tests when evaluating the pain cognition deviation;
the first judging module is used for judging whether the test subject traverses to finish the behavior test of all the behavior testing modules;
the central processing module is used for integrating and analyzing the pain cognition deviation behavior indexes of the subject under different behavior test modules to obtain the overall pain cognition deviation assessment result indexes of the subject;
the second judging module is used for judging whether the pain cognition deviation behavior index of the subject in different behavior tests and the overall pain cognition deviation index of the subject are in a set normal range or not;
and the correction module is used for performing anodic stimulation on the dorsally-lateral forehead cortex of the subject by adopting repetitive transcranial direct current stimulation when the pain cognition deviation behavior index of the subject under different behavior tests and the overall pain cognition deviation assessment result index of the subject exceed the normal range, so that the pain cognition deviation of the subject is corrected.
In this embodiment, comprehensively and comprehensively evaluating pain bias cognition is a precondition of clinical intervention on the pain recovery progress of chronic pain patients, a single pain cognition may not be representative, and a certain degree of singleness is also provided for limiting the regularity of the selection of the subjects, and the combination of evaluation and correction in logic integration is a great breakthrough in the field on the pain intervention level.
In this embodiment, when a subject enters the pain attention deviation behavior test module to perform a pain attention deviation behavior test, the behavior test visual target generation adjustment module generates a "pain+neutral" word visual target, a "gaze point" visual target, a "neutral+neutral" word visual target and a "target stimulus" visual target, adjusts the maintenance time of the "pain+neutral" word visual target, the "gaze point" visual target, the "neutral+neutral" word visual target and the "target stimulus" visual target, and the subject makes a key response to evaluate the attention deviation condition of the subject to the behavior test pain cue visual target; as a specific implementation manner, in this embodiment, the total number of test runs for performing the behavior test is set first, for each test run, the center of the display module displays the "gaze point" visual target for 800ms, and then randomly presents a pair of "pain+neutral" word visual targets or "neutral+neutral" word visual targets for 500ms, see fig. 2, where the "pain+neutral" word visual targets are "burn+read", and for pain words, pain words that characterize physiology, such as stinging, burning, falling, etc., and also social pain words, such as irony, etc.; for neutral words, such as: keys, flowers, walking and the like, different subjects respond differently to pain words of different properties, different test effects are also achieved here, the system is fully integrated and covered, adaptive adjustment and selection can be performed, a target stimulus is displayed for 200ms immediately, for example, a colon, the target stimulus can appear on the left side or the right side, see fig. 2, the colon appears on the left side, the subjects need to respond to the key as soon as possible to the position where the target stimulus appears, and two test time intervals are randomly changed within 400-800 ms. Conventionally, if the subject does not key (left-right hand key) within 2000ms after presentation of the "target stimulus" optotype, the system will automatically jump to the next test run.
When a subject enters a pain interpretation bias behavior test, a behavior test visual target generation adjustment module generates a 'gaze point' visual target, a 'happy face' visual target, a 'pain face' visual target, a 'fuzzy face' visual target and a 'target stimulation' visual target, and adjusts the maintenance time of the 'gaze point' visual target, the 'happy face' visual target, the 'pain face' visual target, the 'fuzzy face' visual target and the 'target stimulation' visual target; one specific representation of the "blurred face" in the "blurred face" visual target, one specific representation of the "happy face" in the "happy face" visual target, and one specific representation of the "painful face" in the "painful face" visual target can be seen in the picture content shown in fig. 3; in the learning stage, the subjects learn the prediction rules of the appearance positions of the happy face and the painful face on the target stimulus, in the testing stage, the subjects respond to the target stimulus after the blurred face visual target by pressing keys, and the subjects are evaluated to interpret the blurred face visual target as the deviation degree of the pain information. Referring to fig. 4, in this embodiment, the accessory learning task optimization paradigm is divided into two phases, firstly, the total number of test times is set, the first phase is a learning phase, the center of the display module presents a "gazing point" visual target for 500ms at the beginning of each test time, then randomly presents a "happy face" visual target or a "painful face" visual target for 675ms, only presents a "target stimulus" visual target, such as letters (see fig. 4"H"), the "target stimulus" visual target may appear on the left side or the right side, the subject needs to perform a key press reaction to the position where the target stimulus appears as soon as possible, and the two test time intervals change randomly between 800 ms and 1200 ms. If the subject does not press a button within 1500ms after the target stimulus is presented, the system will automatically jump to enter the next test. At this stage, the subject needs to learn the location of the different types of facial predictable target stimuli. The second stage is a test stage, in which the center of the display module presents a "gaze point" visual target for 500ms at the beginning of each test, then presents a "happy face" visual target, a "painful face" visual target, a "blurred face" visual target for 675ms, and then presents only a "target stimulus" visual target, such as the letter H, which may appear on the left or right side, in this embodiment, on the right side, the subject needs to perform a key reaction as soon as possible to the position where the "target stimulus" appears, and the two test intervals change randomly from 800 ms to 1200 ms. If the subject does not press a button within 1500ms after the target stimulus is presented, the system will automatically jump to enter the next test. Since during the learning phase the individual has learned the link between the face type and the target stimulation location. Thus, if they respond faster to the target stimulus at the predicted target location of the painful face than to the targets at other locations, it is stated that there is a bias in interpretation of pain for the ambiguous face and the difference in key responses to the target stimulus at both locations reflects the extent of the bias in interpretation of pain. When a subject enters a pain memory bias behavior test, a behavior test visual target generation and adjustment module generates a 'gaze point' visual target, a 'pain' picture and a 'non-pain' picture, and adjusts the maintenance time of the 'gaze point' visual target, the 'pain' picture and the 'non-pain' picture, and the subject memorizes the 'pain' picture and the 'non-pain' picture, wherein the 'pain' picture and the 'non-pain' picture can be characterized as picture contents shown in fig. 5; then entering a re-recognition stage of the pain picture and the non-pain picture, making a key response, and evaluating the memory deflection degree of the subject on the pain information; specific procedure referring to fig. 6, the pain memory bias behavior test is divided into two phases, the first phase being a memory phase, and the subject only needs to memorize the presented "pain" picture or "non-pain" picture as much as possible without any key-press reaction. The display module presents a "point of regard" optotype for 500ms in the center at the beginning of each test run, followed by a picture for 3000ms, with two test run intervals randomly varying from 800 to 1200 ms. After the memory phase is completed, the subject is asked to rest forcefully for 3 minutes, and then to enter a reconfirmation phase. In the reconfirming stage, the subject needs to press keys to judge whether the presented picture appears in the memorizing stage. And presenting a 'fixation point' visual target for 500ms at the center of the display module at the beginning of each test time, then presenting a picture, and if the subject does not press keys within 3000ms after the picture presentation, automatically jumping to the next interface by the system. The two test intervals varied randomly from 800 to 1200 ms. Recall that the difference in accuracy for the two types of pictures reflects the degree of memory bias. When a subject enters a pain implicit negative bias behavior test, a behavior test visual target generation and adjustment module generates a pain word visual target, a non-pain word visual target, a negative emotion word visual target and a neutral emotion word visual target, and the task model optimization module introduces the negative emotion word visual target into an implicit association test task optimization model, so that 3 matched display tested parts are formed between the pain word visual target, the non-pain word visual target, the negative emotion word visual target and the neutral emotion word visual target for classifying the subject and performing key reaction, an implicit association test task optimization model is formed, and the negative implicit attitude intensity of the subject is evaluated. The 3 parts for the fit display test include: in the practice section, the subject distinguishes between "painful" and "non-painful" targets, and between "negative and" neutral "targets; in the compatibility condition part, matching the 'painful words' optotypes with the 'negative emotion words' optotypes and assigning the same key, matching the 'non-painful words' optotypes with the 'neutral emotion words' optotypes and assigning the same key, and requiring the tested to perform key reaction on the presented words according to the matching rule; in the non-compatible condition part, the 'painful word' visual target is matched with the 'neutral emotion word' visual target and is allocated with the same key, the 'non-painful word' visual target is matched with the 'negative emotion word' visual target and is allocated with the same key, and the key response of the presented words is required to be carried out by the tested according to the matching rule. The implicit negative bias of the subject on pain information is assessed by comparing key responses under compatible and incompatible conditions.
Specifically, referring to fig. 7, the process includes:
the target words are divided into two categories: "painful" optotypes, "non-painful" optotypes; attribute words are also divided into two categories: "negative emotion word" optotype, "neutral emotion word" optotype. "pain word" may be characterized by specific words such as stinging, colic, sharp pain, etc.; "non-painful words" may be characterized as specific words such as touch, stroker, tap, etc.; "negative mood words" may be characterized as specific words such as tension, disconcerting, fear, and the like; "neutral mood words" may be characterized as specific words such as deposition, relaxation, calm, etc.; during the whole process, the subject needs to press the "F" key and the "J" key with the index finger of the left hand and the right hand respectively. The program consists of 7 parts. The 3 rd, 4 th, 6 th and 7 th parts (third compatible condition part "pain word" optotype pair "negative emotion word" optotype+non-pain word "optotype pair" neutral emotion word "optotype, fourth compatible condition part" pain word "optotype pair" negative emotion word "optotype+non-pain word" optotype pair "neutral emotion word" optotype, sixth incompatible condition part "pain word" optotype+non-pain word "optotype pair" negative emotion word "optotype and seventh incompatible condition part" pain word "optotype pair" neutral emotion word+non-pain word "optotype pair" negative emotion word "optotype) are test parts for relative formal training, and the 1 st, 2 th and 5 th parts (first training part" pain word "optotype+non-pain word" optotype, second training part "negative emotion word" negative emotion word+ "neutral emotion word" optotype, fifth non-compatibility word "negative emotion word" optotype) are test parts for training of the subjects. Wherein parts 3 and 4 are in a compatible condition and parts 6 and 7 are in a non-compatible condition. In compatible conditions (pain word and negative word pairing), the subject needs to react to the same key (e.g., "F") for pain and negative words, and to press another key (e.g., "J") for non-pain and neutral words. In contrast, in a non-compatible condition (pain word and neutral word pairing), the subject needs to react to the same key (e.g., "F") for pain and neutral words, and to press another key (e.g., "J") for non-pain and negative words. In section 1, the subject is required to practice categorizing painful and non-painful words and making corresponding key responses; in section 2, the subject needs to exercise categorizing negative and neutral words and make the corresponding key reactions. In section 5, the subject needs to classify the negative and neutral terms again, but the key assignment of the attribute terms is opposite to section 2. All subjects must practice until they reach 80% accuracy in the part of the practice, and then cannot go into the stage of formal combination classification.
And a visual target with 'negative' property is introduced in the test process to carry out implicit negative bias test, so that the implicit negative attitude of a pain cognition layer on pain information of a subject is perfected and optimized, the traditional implicit association test task paradigm is optimized, and the Response Time (RT) and the Accuracy (ACC) of each subject are recorded. Feedback only occurs after the wrong test run (lasting the 1000ms "x" symbol) in order to make adjustments in time in the following test run. The interval time between two trials varies randomly between 2000 and 4000 ms.
In addition, referring to fig. 1, the system further includes:
the acquisition preset module is used for acquiring pain cognition deviation behavior index data of N individuals under different behavior tests and the total pain cognition deviation assessment result index number of the N individuals in advanceAccording to the condition, N is a positive number capable of representing the current situation of universality, pain cognition deviation behavior index data of N individuals under different behavior tests and pain cognition deviation evaluation result index data of N individual populations are respectively subjected to normal distribution, and negative standard deviation-sigma of each individual population is takenj And positive standard deviation +sigmaj Composition interval (-sigma)j ，+σj ) As a normal range in which the pain cognition bias is set, if the pain cognition bias exceeds the normal range, judging that the pain cognition bias is abnormal, j represents the sequence of the pain cognition bias behavior indexes, and represents one of the pain cognition bias behavior indexes of N individuals under different behavior tests and the pain cognition bias evaluation result indexes of N individuals as a whole;
When the pain cognition deviation behavior index of the subject under different behavior tests and the overall pain cognition deviation assessment result index of the subject correspond to the interval (-sigma)j ，+σj ) In the internal time, the pain cognition of the subject is biased to be normal and does not need correction; when the pain cognition deviation behavior index of the subject under different behavior tests and the overall pain cognition deviation assessment result index of the subject exceed the interval (-sigma)j ，+σj ) When the pain cognition bias of the subject exceeds the set normal range, the correction is needed;
when the pain cognitive deviation of the subject exceeds a set normal range, the correction module carries out anodic stimulation on the dorsolateral forehead cortex of the subject by using transcranial direct current stimulation, the stimulation period is two weeks, the frequency is once daily, each time lasts for 20 minutes, and each time lasts for no more than 20 minutes.
Example 2
As shown in fig. 8, the present invention further provides a method for correcting a pain cognition bias evaluation based on a behavioral test, which is implemented based on the pain cognition bias evaluation correction system described in embodiment 1, and includes:
s1, selecting and switching the sequence of entering a plurality of behavior test modules by a mode selection switching module according to the actual psychological tendency condition of the subject at the pain cognition deviation evaluation moment;
S2, determining a first behavior test module selected by a subject, entering the first behavior test module, and starting pain cognition bias evaluation based on the behavior test of the module;
s3, generating and adjusting a behavioral test visual target by a behavioral test visual target generation and adjustment module according to the behavioral test performed by the subject;
s4, displaying a behavioral test pain cue visual target required by the behavioral test of the subject through a display module, observing the behavioral test pain cue visual target by the subject, and performing key-press reaction under a task paradigm in the behavioral test;
s5, recording key response of the subject under the behavior test by using a statistics module, and counting pain cognition deviation behavior indexes of the subject under different behavior tests;
s6, judging whether the test subject has traversed to finish the behavior test of all the behavior test modules by using the first judging module, if so, executing the step S7; otherwise, entering the next behavior testing module according to the sequence of entering a plurality of behavior testing modules in the step S1, starting pain cognition deviation assessment based on the behavior testing of the module, and returning to the step S3;
s7, integrating and analyzing pain cognition deviation behavior data of the subject under different behavior tests through a central processing module to obtain a pain cognition deviation assessment result index of the overall subject, and executing a step S8;
S8, judging whether the pain cognition deviation behavior indexes of the subject and the overall pain cognition deviation assessment result indexes of the subject under different behavior tests are in a set normal range or not through a second judging module, if so, storing the pain cognition deviation behavior indexes of the subject under different behavior tests and the overall pain cognition deviation assessment result indexes of the subject without correction treatment; otherwise, anodal stimulation of the dorsolateral prefrontal cortex of the subject with repeated transcranial direct current stimulation is performed by the correction module to help correct excessive pain cognitive bias.
In step S1, the plurality of behavioral testing modules include a pain attention deviation behavioral testing module, a pain interpretation deviation behavioral testing module, a pain memory deviation behavioral testing module and a pain implicit deviation behavioral testing module, and when the pain cognition deviation is evaluated, the mode selection switching module is provided with characteristic labels respectively representing specific testing attributes of the pain attention deviation behavioral testing module, the pain interpretation deviation behavioral testing module, the pain memory deviation behavioral testing module and the pain implicit deviation behavioral testing module, and the subject generates psychological tendency selection according to the observed characteristic labels at the evaluation moment, determines the sequence of entering the plurality of behavioral testing modules, and starts to evaluate different pain cognition deviations based on behavioral tests.
In this embodiment, a task paradigm is implemented by using a plurality of behaviors, and besides comprehensively evaluating the attention, explanation, memory and implicit bias of the individual to the pain related information, the processing procedure of the subject to the pain cognition is refined and evaluated through the stage formed by the cognitive processing of the subject, and finally the cognitive bias characteristics of different dimensions can be integrated, so that the current gap of evaluation and research on the pain cognition is filled.
In step S5, the statistics of the pain cognition deviation behavior indexes of the subject under the task paradigm in different behavior tests includes: attention to the directional acceleration index y1 Difficulty in paying attention to index y2 Deviation index y of pain interpretation3 Memory bias index y for pain4 Implicit deviation index y of pain5 ；
The attention oriented acceleration index y1 Expressed as:
y1 ＝RTneu -RTcong
attention release difficulty index y2 Expressed as:
y2 ＝RTIncong -RTneu
wherein RTneu Indicating that the subject is not noticing the correct average response of the key responses of the allocation test times; RT (reverse transcription) methodcong Indicating that the subject is in a consistent test time when the key response is correct; RT (reverse transcription) methodIncong Indicating that the subject is in a non-uniform test time when the key response is correct; the non-injectionThe intended allocation test represents an evaluation test in which the "neutral + neutral" word optotype appears, the consistency test represents an evaluation test in which the "target stimulus" optotype appears at the same side of pain, and the non-consistency test represents an evaluation test in which the "target stimulus" optotype appears at the opposite side of pain; if y1 > 0, indicating that the subject responds faster to the target stimulus at the predicted location of pain, with a marked acceleration of attention; if y2 > 0, indicating that the subject responded more slowly to the contralateral site of pain, indicating that the subject had difficulty in resolving attention.
The pain interpretation bias index y3 Expressed as:
y3 ＝RThappy -RTpain
wherein RThappy And RTpain All represent the subject's response to "target stimulus" following "blurred face" during the test phase, RThappy Is the position of the target stimulus predicted by the "happy face" target in the learning phase, RTpain Is the position of the target stimulus predicted by the "pain face" optotype in which the "target stimulus" optotype appears in the learning phase; if y3 > 0, indicating that the subject can easily interpret "blurred faces" as "painful faces", and that the subject has a bias in pain interpretation;
pain memory deflection index y4 Expressed as:
y4 ＝ACCpain -ACCneu
wherein ACCpain Indicating the recall correctness of the subject to the "pain" picture, ACCneu Indicating the recall correctness of the subject for the "non-painful" picture, if y4 > 0, indicating that the subject has better memory effect on pain pictures, i.e., the subject has pain memory bias;
implicit deviation index y of pain5 Expressed as:
Wherein M isincong Average key reaction of the subject under incompatible conditions; m is Mcong Mean key response of subjects under compatible conditions is indicated, SDincong，cong Combining standard deviation for compatible and incompatible test runs; if y5 > 0, indicating that the subject has a tighter linkage to the pain-negative mood word, with a bias in pain incapacitation;
the expression of the overall pain cognitive bias assessment result index of the subject obtained in the step S7 is as follows:
wherein i represents the attention directed acceleration index y1 Difficulty in paying attention to index y2 Deviation index y of pain interpretation3 Memory bias index y for pain4 Implicit deviation index y of pain5 Any one of the sequences; y isi Indicating the attention-directed acceleration index y1 Difficulty in paying attention to index y2 Deviation index y of pain interpretation3 Memory bias index y for pain4 Implicit deviation index y of pain5 N represents the number of indices.
The process of setting standard in step S8 is as follows:
the method comprises the steps of collecting pain cognition deviation behavior index data of N individuals under different behavior tests and pain cognition deviation assessment result index data of N individual populations in advance, wherein N is a positive number capable of representing the current situation of universality, respectively making positive distribution of the pain cognition deviation behavior index data of N individuals under different behavior tests and the pain cognition deviation assessment result index data of N individual populations, and taking respective negative standard deviation-sigmaj And positive standard deviation +sigmaj Composition interval (-sigma)j ，+σj ) As a normal range in which the pain cognition bias is set, if the pain cognition bias exceeds the normal range, the pain cognition bias abnormality is judged, j represents the sequence of the pain cognition bias behavior indexes, and represents the pain cognition bias behavior indexes of N individuals under different behavior tests,Pain cognition bias in the N individual populations evaluates one of the outcome indicators.
After anodal stimulation is performed on the dorsolateral forehead cortex of the subject by the correction module through repeated transcranial direct current stimulation, the pain cognition deviation assessment correction method based on the behavior test further comprises the following steps:
after the correction by the correction module is finished, returning to the step S1 to start pain cognition deviation assessment again until the pain cognition deviation behavior index and the overall pain cognition deviation assessment result index of the subject under different behavior tests are positioned in the normal range of cognition deviation, and performing no correction treatment.
The positional relationship depicted in the drawings is for illustrative purposes only and is not to be construed as limiting the present patent;
it is to be understood that the above examples of the present invention are provided by way of illustration only and are not intended to limit the scope of the invention. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. Any modification, equivalent replacement, improvement, etc. which come within the spirit and principles of the invention are desired to be protected by the following claims.