Holtzman Susan, Delongis Anita
Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, Canada V6T 1Z4.
Pain. 2007 Sep;131(1-2):202-13. doi: 10.1016/j.pain.2007.04.005. Epub 2007 May 22.
The majority of research on pain catastrophizing has focused on its negative consequences for adjustment to chronic pain, with few investigations of factors that influence catastrophizing or its detrimental effects. Using a daily process methodology, the current study examined, first, the extent to which a supportive social environment plays a role in reduced catastrophizing, and second, the extent to which support might protect against the detrimental effects of catastrophizing on well-being. Sixty-nine married individuals with rheumatoid arthritis took part in an initial background interview, followed by twice daily telephone interviews (regarding pain intensity, negative affect, catastrophizing and satisfaction with spouse responses) for 1 week. Multi-level modeling indicated several pathways through which satisfaction with spouse responses disrupts the vicious cycle of pain, negative affect and catastrophizing. Consistent with past research, catastrophizing was associated with increases in pain and negative affect. However, when individuals reported increases in satisfaction with spouse responses they were less likely to experience increases in negative affect due to catastrophizing. Satisfaction with spouse responses also reduced the likelihood of feeling overwhelmed and helpless in dealing with daily pain. The relationship between pain and catastrophizing was attenuated in the context of increases in satisfaction with spouse responses. Negative affect was associated with increases in catastrophizing, but only when individuals reported decreases in satisfaction with spouse responses. Overall, findings were consistent with a model in which satisfaction with spouse responses serves as a coping resource, and suggests the importance of involving close others in treatments to reduce pain and catastrophizing.
大多数关于疼痛灾难化的研究都集中在其对慢性疼痛适应的负面影响上，而对影响灾难化的因素或其有害影响的调查较少。本研究采用每日过程法，首先考察支持性社会环境在减少灾难化方面所起的作用程度，其次考察支持在多大程度上可以抵御灾难化对幸福感的有害影响。69名患有类风湿性关节炎的已婚个体参加了一次初始背景访谈，随后进行了为期1周的每日两次电话访谈（涉及疼痛强度、消极情绪、灾难化以及对配偶反应的满意度）。多层次模型表明了配偶反应满意度打破疼痛、消极情绪和灾难化恶性循环的几种途径。与过去的研究一致，灾难化与疼痛和消极情绪的增加有关。然而，当个体报告对配偶反应的满意度增加时，他们因灾难化而经历消极情绪增加的可能性较小。对配偶反应的满意度也降低了在应对日常疼痛时感到不堪重负和无助的可能性。在对配偶反应的满意度增加的情况下，疼痛与灾难化之间的关系减弱。消极情绪与灾难化的增加有关，但仅当个体报告对配偶反应的满意度下降时才会如此。总体而言，研究结果与一个模型一致，即对配偶反应的满意度作为一种应对资源，并表明让亲密他人参与治疗以减轻疼痛和灾难化的重要性。
