Evans Susan, Weinberg Beth A, Spielman Lisa, Fishman Baruch
Department of Psychiatry, Weill Medical College of Cornell University, 425 East 61st Street, Suite 1350, New York, NY 10021, USA.
Pain. 2003 Sep;105(1-2):239-45. doi: 10.1016/s0304-3959(03)00220-3.
A growing body of literature suggests that negative thoughts and interpretations in response to pain can significantly increase the suffering associated with the pain experience. As part of an outcome study on a cognitive-behavioral treatment for HIV-related peripheral neuropathic pain, 85 seropositive men and women were administered the inventory of negative thoughts in response to pain (INTRP), a self-report assessment that includes three subscales: negative self-statements, negative social cognitions and self-blame. Pearson product moment correlations coefficients were calculated between INTRP scores and pain and distress ratings. A series of regression analyses were performed to determine predictors of pain and distress. Results demonstrated highly significant associations between the negative self-statements and negative social cognitions and pain intensity. Highly significant associations were also found between negative self-statements, negative social cognitions, self-blame and measures of pain interference, affective symptoms and distress. Additionally, negative cognitions significantly predicted interference in daily functional activities, overall distress and affective symptoms. Future directions for developing and testing cognitive-behavioral treatments for restructuring dysfunctional cognitions are indicated. Finally, internal scale reliability of the INTRP was shown to be moderately high and this study offers construct validity of the INTRP as a useful tool for assessing thoughts in response to pain in people with HIV.
越来越多的文献表明，对疼痛的消极思维和解读会显著增加与疼痛体验相关的痛苦。作为一项针对与HIV相关的外周神经病理性疼痛的认知行为治疗的结果研究的一部分，85名血清反应呈阳性的男性和女性接受了疼痛消极思维量表（INTRP）测试，这是一种自我报告评估工具，包括三个子量表：消极自我陈述、消极社会认知和自责。计算了INTRP得分与疼痛及痛苦评分之间的皮尔逊积差相关系数。进行了一系列回归分析以确定疼痛和痛苦的预测因素。结果表明，消极自我陈述和消极社会认知与疼痛强度之间存在高度显著的关联。在消极自我陈述、消极社会认知、自责与疼痛干扰、情感症状和痛苦测量之间也发现了高度显著的关联。此外，消极认知显著预测了对日常功能活动的干扰、总体痛苦和情感症状。文中指出了未来开发和测试用于重构功能失调认知的认知行为治疗方法的方向。最后，研究表明INTRP的内部量表信度处于中等偏高水平，并且本研究为INTRP作为评估HIV感染者疼痛相关思维的有用工具提供了结构效度。
