Smith Julie A, Lumley Mark A, Longo David J
Wayne State University, Detroit, Michigan, USA.
Ann Behav Med. 2002 Fall;24(4):326-35. doi: 10.1207/S15324796ABM2404_09.
Passive or emotion-focused coping strategies are typically related to worse pain and adjustment among chronic pain patients. Emotional approach coping (EAC), however, is a type of emotion-focused coping that appears to be adaptive in some nonpain populations but has not yet been examined in a chronic pain population. In a sample of 80 patients (75% women, M = 48.67 years of age) with chronic myofascial pain, we contrasted how EAC (assessed with the Emotional Approach Coping Scale) and 5 passive pain-coping strategies (assessed with the Vanderbilt Multidimensional Pain Coping Inventory (VMPCI)) were related to sensory and affective pain, physical impairment, and depression. Passive coping strategies were positively correlated with one another, but EAC was inversely correlated with most of them. The VMPCI passive strategies were substantially positively related to negative affect, whereas EAC was inversely related to negative affect. Controlling for potentially confounding demographics, higher EAC was related to less affective pain and depression, even after controlling for negative affect. Using passive coping strategies, in contrast, was associated with more pain, impairment, and depression, although these relations were greatly attenuated after controlling for negative affect. When considered simultaneously, EAC, but not passive coping, was related to affective pain, and both EAC and passive coping were significant correlates of depression, although in opposite directions. In secondary analyses, we found that EAC was related to less pain (particularly sensory) among men and to less depression among women. Unlike the use of passive pain-coping strategies, which are associated with worse pain and adjustment, the use of EAC (emotional processing and emotional expression) with chronic pain is associated with less pain and depression. This suggests that some emotion-focused types of pain coping may be adaptive, and it highlights the need to assess emotional coping processes that are not confounded with distress or dysfunction.
被动应对策略或聚焦情绪的应对策略通常与慢性疼痛患者更糟糕的疼痛状况和适应情况相关。然而，情绪趋近应对（EAC）是一种聚焦情绪的应对方式，在一些非疼痛人群中似乎具有适应性，但尚未在慢性疼痛人群中得到研究。在一个由80名慢性肌筋膜疼痛患者组成的样本中（75%为女性，平均年龄M = 48.67岁），我们对比了EAC（用情绪趋近应对量表评估）和5种被动疼痛应对策略（用范德比尔特多维疼痛应对量表（VMPCI）评估）与感觉性疼痛和情感性疼痛、身体功能障碍以及抑郁之间的关系。被动应对策略之间呈正相关，但EAC与其中大多数呈负相关。VMPCI被动策略与消极情绪显著正相关，而EAC与消极情绪呈负相关。在控制了可能产生混淆的人口统计学因素后，即使在控制了消极情绪之后，较高的EAC仍与较少的情感性疼痛和抑郁相关。相比之下，使用被动应对策略与更多的疼痛、功能障碍和抑郁相关，尽管在控制了消极情绪后这些关系大大减弱。同时考虑时，EAC而非被动应对与情感性疼痛相关，EAC和被动应对都是抑郁的显著相关因素，尽管方向相反。在二次分析中，我们发现EAC与男性较少的疼痛（尤其是感觉性疼痛）以及女性较少的抑郁相关。与使用被动疼痛应对策略会导致更糟糕的疼痛状况和适应情况不同，在慢性疼痛中使用EAC（情绪处理和情绪表达）与较少的疼痛和抑郁相关。这表明某些聚焦情绪的疼痛应对方式可能具有适应性，并且凸显了评估不与痛苦或功能障碍混淆的情绪应对过程的必要性。
