Sinclair V G
Vanderbilt University School of Nursing, Nashville, TN 37240, USA.
Arch Psychiatr Nurs. 2001 Dec;15(6):279-88. doi: 10.1053/apnu.2001.28686.
Catastrophizing has been conceptualized as an appraisal, a cognitive distortion, and a coping mechanism in the psychosocial literature. Regardless of its conceptualization, catastrophizing has been associated with negative psychological and physical outcomes in numerous studies, including our intervention study with 90 women with rheumatoid arthritis. Because of catastrophizing's robust relationship with negative outcomes, predictors of catastrophizing as a pain coping behavior were investigated in this sample, using data collected from two points in time before the intervention. Using Lazarus and Folkman's stress and coping theoretical framework to guide the analyses, variables with a proximal relationship to catastrophizing in the framework were examined for significant associations with pain catastrophizing using correlational analyses. Subsequent stepwise regression involving all variables from Time 1 with significant associations resulted in a model that explained 63% of the variance in Time 2 pain catastrophizing scores. The four predictors in this model were dispositional pessimism, passive pain coping, venting (as a pain coping behavior), and arthritis helplessness. Potential clinical implications related to these predictors are also discussed. Knowledge about predictors of catastrophizing may enhance efforts to address this maladaptive pattern through educational and therapeutic approaches.
在社会心理学文献中，灾难化思维被概念化为一种评价、一种认知扭曲和一种应对机制。无论其概念如何，在众多研究中，灾难化思维都与负面的心理和生理结果相关，包括我们对90名类风湿性关节炎女性进行的干预研究。由于灾难化思维与负面结果之间存在密切关系，本研究使用干预前两个时间点收集的数据，对该样本中作为疼痛应对行为的灾难化思维的预测因素进行了调查。以拉扎勒斯和福克曼的压力与应对理论框架为指导进行分析，使用相关分析检查该框架中与灾难化思维有近端关系的变量与疼痛灾难化思维之间的显著关联。随后对来自时间1的所有具有显著关联的变量进行逐步回归，得到一个模型，该模型解释了时间2疼痛灾难化思维得分中63%的方差。该模型中的四个预测因素是性格悲观、消极疼痛应对、发泄（作为一种疼痛应对行为）和关节炎无助感。还讨论了与这些预测因素相关的潜在临床意义。了解灾难化思维的预测因素可能会加强通过教育和治疗方法来解决这种适应不良模式的努力。
