Hirsh Adam T, George Steven Z, Riley Joseph L, Robinson Michael E
Center for Pain Research and Behavioral Health, University of Florida, P.O. Box 100165 HSC, Gainesville, FL 32610-0165, United States.
Eur J Pain. 2007 Jan;11(1):75-81. doi: 10.1016/j.ejpain.2005.12.010. Epub 2006 Mar 20.
Measurement and conceptual issues of pain catastrophizing have been raised in the literature. The issues of construct redundancy and measurement overlap have received particular attention, with suggestions that measures of pain catastrophizing are confounded with measures of negative mood, namely depression. The current study sought to investigate these issues in the coping strategies questionnaire-catastrophizing subscale (CSQ-CAT), a widely used measure of pain catastrophizing. Chronic pain patients (n=152) were recruited from the University of Florida pain clinics and completed a battery of psychological measures. Regression analyses indicated that measures of depression, anxiety, and anger accounted for 69% and 19% of the variance in measures of pain catastrophizing and pain, respectively. Trait anger and the cognitive and fearful dimensions of depression and anxiety were uniquely associated with pain catastrophizing. After controlling for measures of negative mood, pain catastrophizing contributed minimally to the prediction of pain. This study suggests that the CSQ-CAT is highly related to measures of negative mood and raises doubts about its measurement of the construct of pain catastrophizing. Results also provide support for theoretical accounts of the relationships between pain catastrophizing, negative mood, and pain. Clinical implications, future research directions, and alternative measures of pain catastrophizing are discussed.
文献中已经提出了疼痛灾难化的测量和概念问题。结构冗余和测量重叠的问题受到了特别关注,有人认为疼痛灾难化的测量与消极情绪(即抑郁)的测量相互混淆。本研究旨在调查应对策略问卷-灾难化分量表(CSQ-CAT)中的这些问题,这是一种广泛使用的疼痛灾难化测量工具。从佛罗里达大学疼痛诊所招募了慢性疼痛患者(n = 152),并让他们完成了一系列心理测量。回归分析表明,抑郁、焦虑和愤怒的测量分别占疼痛灾难化测量和疼痛测量中变异的69%和19%。特质愤怒以及抑郁和焦虑的认知和恐惧维度与疼痛灾难化有独特的关联。在控制了消极情绪的测量后,疼痛灾难化对疼痛预测的贡献微乎其微。本研究表明,CSQ-CAT与消极情绪的测量高度相关,并对其对疼痛灾难化结构的测量提出了质疑。研究结果也为疼痛灾难化、消极情绪和疼痛之间关系的理论解释提供了支持。讨论了临床意义、未来研究方向以及疼痛灾难化的替代测量方法。