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Modificación de sesgos cognitivos para la interpretación que mitiga la hiperalgesia por nocebo

Tessa Rooney¹, Louise Sharpe¹, Jemma Todd¹

¹School of Psychology, The University of Sydney, Australia.

The journal of pain

|December 20, 2025

Resumen

La modificación de los sesgos de interpretación hacia el dolor aumentó la hiperalgesia por nocebo, mediada por la expectativa de dolor. La reducción de las interpretaciones relacionadas con el dolor puede ser un objetivo para la reducción del dolor por nocebo en entornos clínicos.

Palabras clave:

modificación de sesgos cognitivos para la interpretación sesgo de interpretación expectativa negativa hiperalgesia por nocebo dolor

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Área de la Ciencia:

Psicología
Ciencia del Dolor
Neurociencia Cognitiva

Sus antecedentes:

El sesgo de interpretación, la tendencia a interpretar estímulos ambiguos como relacionados con el dolor, se correlaciona con la gravedad del dolor.
Comprender los mecanismos de la hiperalgesia por nocebo es crucial para desarrollar estrategias efectivas de manejo del dolor.

Objetivo del estudio:

Investigar si la modificación del sesgo cognitivo para la interpretación (CBM-I) influye en la hiperalgesia por nocebo.
Determinar el papel mediador de la expectativa de dolor en la relación entre el sesgo de interpretación y la hiperalgesia por nocebo.

Principales métodos:

Los participantes fueron asignados aleatoriamente a CBM-I dirigida a interpretaciones relacionadas con el dolor o benignas.
El procedimiento de inducción de nocebo implicó una estimulación eléctrica nerviosa transcutánea (TENS) simulada emparejada con dolor térmico.
La hiperalgesia por nocebo se evaluó comparando las calificaciones del dolor durante las pruebas de TENS y sin TENS en condiciones de estímulos térmicos idénticos.

Principales resultados:

La hiperalgesia por nocebo se observó de manera confiable y fue mediada por la expectativa de dolor.
La CBM-I manipuló con éxito el sesgo de interpretación, y el grupo con sesgo de dolor mostró un sesgo más fuerte.
Los participantes que recibieron CBM-I centrada en el dolor exhibieron una hiperalgesia por nocebo significativamente mayor en comparación con el grupo centrado en lo benigno.

Conclusiones:

La modificación del sesgo cognitivo dirigida a interpretaciones relacionadas con el dolor amplifica la hiperalgesia por nocebo.
El sesgo de interpretación juega un papel causal en la hiperalgesia por nocebo a través de una mayor expectativa de dolor.
La reducción de los sesgos de interpretación relacionados con el dolor a través de CBM-I presenta una intervención psicológica potencial para el manejo del dolor clínico.