Helmes Edward, Goburdhun Anjali
School of Psychology, James Cook University, Townsville Qld 4811, Australia.
Clin J Pain. 2007 Jan;23(1):53-61. doi: 10.1097/01.ajp.0000210942.81310.ed.
The assessment of cognitive reactions to chronic pain is less well developed than other areas of pain assessment. The aim of the first study was to revise the Cognitive Evaluation Questionnaire of Philips whereas the second study examined its properties and validity in a new sample of people with chronic pain.
The revised scale underwent item analysis in 87 undergraduates, all of whom had pain of at least 1-month duration during the previous year, and was correlated with Skevington's Beliefs about Pain Control Questionnaire and 3 ratings of pain severity over time. In a second study, 96 participants with chronic pain (50 females) completed the Revised Cognitive Evaluation Questionnaire, the Survey of Pain Attitudes-Brief, the Center for Epidemiologic Studies Depression Scale, and sections of the Sickness Impact Profile. Hierarchical regression examined the construct validity of the revised scales in relation to psychosocial functioning and depression.
Results showed acceptable internal consistency in both samples, and significant correlations with pain severity and the beliefs scales in Study 1. In Study 2, all but 2 scales showed correlations with the measure of beliefs about pain. The hierarchical multiple regression results showed that only Disability belief predicted psychosocial functioning, whereas Control from the beliefs measure and the new revised Causal Rumination and Concern with Effects of Pain scales predicted the CES-D depression scores.
The revised cognitive scales in themselves were significant predictors in Study 2, and their contribution was more effective for depression than for psychosocial functioning. The results showed promise for the revised scale and are discussed in relation to previous research, with recommendations for future research into the cognitive reactions of individuals with chronic pain.
与疼痛评估的其他领域相比，对慢性疼痛认知反应的评估发展较不完善。第一项研究的目的是修订飞利浦认知评估问卷，而第二项研究则在一个新的慢性疼痛患者样本中检验其特性和效度。
修订后的量表在87名本科生中进行了项目分析，他们所有人在上一年都经历了至少1个月的疼痛，并与斯凯夫顿疼痛控制信念问卷以及3个不同时间点的疼痛严重程度评分相关联。在第二项研究中，96名慢性疼痛患者（50名女性）完成了修订后的认知评估问卷、疼痛态度简要调查问卷、流行病学研究中心抑郁量表以及疾病影响概况的部分内容。分层回归分析检验了修订后量表与心理社会功能和抑郁之间的结构效度。
结果显示两个样本的内部一致性均可接受，并且在研究1中与疼痛严重程度和信念量表存在显著相关性。在研究2中，除2个量表外，所有量表均与疼痛信念测量指标存在相关性。分层多元回归结果显示，只有残疾信念可预测心理社会功能，而信念测量指标中的控制以及新修订的因果反刍和对疼痛影响的关注量表可预测CES-D抑郁评分。
修订后的认知量表本身在研究2中是显著的预测指标，并且它们对抑郁的作用比对心理社会功能的作用更有效。研究结果显示了修订后量表的前景，并结合先前的研究进行了讨论，同时为未来关于慢性疼痛患者认知反应的研究提出了建议。
