Martin Andrea L, McGrath Patricia A, Brown Stephen C, Katz Joel
Department of Anesthesia, Divisional Centre for Pain Management and Research, The Hospital for Sick Children, Toronto, Canada.
Pain Res Manag. 2007 Winter;12(4):267-72. doi: 10.1155/2007/897395.
Converging lines of evidence suggest that anxiety sensitivity and fear of pain may be important vulnerability factors in the development of avoidance behaviours and disability in adults with chronic pain. However, these factors have not been evaluated in children with chronic pain.
To examine the relationships among anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain.
An interview and five questionnaires (Childhood Anxiety Sensitivity Index, Pain Anxiety Symptoms Scale, Functional Disability Inventory, Multidimensional Anxiety Scale for Children, and Reynolds Child or Adolescent Depression Scale) were administered to 21 children and adolescents eight to 17 years of age (mean +/- SD 14.24+/-2.21 years) who continued to experience pain an average of three years after discharge from a specialized pain clinic for children.
Anxiety sensitivity accounted for 38.6% of the variance in fear of pain (F[1,20]=11.30; P=0.003) and fear of pain accounted for 39.9% of the variance in pain-related disability (F[1,20]=11.95; P=0.003), but anxiety sensitivity was not significantly related to pain disability (R2=0.09; P>0.05).
These findings indicate that children with high levels of anxiety sensitivity had a higher fear of pain, which, in turn, was linked to increased pain disability. The results of this study suggest that anxiety sensitivity and fear of pain may play important and distinct roles in the processes that maintain chronic pain and pain-related disability in children.
越来越多的证据表明，焦虑敏感性和对疼痛的恐惧可能是慢性疼痛成人出现回避行为和残疾的重要易患因素。然而，这些因素尚未在慢性疼痛儿童中得到评估。
探讨慢性疼痛儿童和青少年中焦虑敏感性、对疼痛的恐惧与疼痛相关残疾之间的关系。
对21名8至17岁（平均±标准差14.24±2.21岁）的儿童和青少年进行了访谈，并发放了五份问卷（儿童焦虑敏感性指数、疼痛焦虑症状量表、功能残疾量表、儿童多维焦虑量表和雷诺兹儿童或青少年抑郁量表），这些儿童在从儿童专科疼痛诊所出院后平均持续疼痛三年。
焦虑敏感性占疼痛恐惧方差的38.6%（F[1,20]=11.30；P=0.003），疼痛恐惧占疼痛相关残疾方差的39.9%（F[1,20]=11.95；P=0.003），但焦虑敏感性与疼痛残疾无显著相关性（R2=0.09；P>0.05）。
这些发现表明，焦虑敏感性高的儿童对疼痛的恐惧更高，而这又与疼痛残疾增加有关。本研究结果表明，焦虑敏感性和对疼痛的恐惧可能在维持儿童慢性疼痛和疼痛相关残疾的过程中发挥重要且不同的作用。
