Klages U
Poliklinik für Kieferorthopädie, Johannes-Gutenberg-Universität, Augustusplatz 2, D-6500, Mainz.
Schmerz. 1990 Mar;4(1):37-41. doi: 10.1007/BF02527828.
The relationship of patients' pain with emotions and irrational attitudes were reported. The subjects were 128 patients with rheumatoid arthritis (RA). The assessment instruments were the Situation-Reaction Questionnaire (SRQ) and the Irrational Attitudes Questionnaire (IAQ). Pain experience was measured by a pain-attribute scale and a visual analog scale, and reported pain behavior by two scales for assessing avoidance and activity in pain situations. The medical control variables were morning stiffness and two indexes of process activity and joint inflammation. Hierarchical regression analyses showed (after the inclusion of medical variables) that affect scales (depression, anxiety, aggression) contribute significantly to the explanation of the variation of pain experience (adjective scale: 3%) and reported pain behavior (avoidance: 11%, activity: 6%). When disease activity and emotions were held constant, the IAQ explained a further 11-14% of pain experience and pain behavior. On the other hand, when medical variables and irrational attitudes were controlled, emotions showed no common variation to pain. According to our results, cognitive concepts seem to be more powerful for explaining pain experience and pain behavior than affective constructions. Implications for the study and the practice of psychological pain treatment are discussed.
报告了患者疼痛与情绪及非理性态度之间的关系。研究对象为128名类风湿性关节炎（RA）患者。评估工具为情境 - 反应问卷（SRQ）和非理性态度问卷（IAQ）。疼痛体验通过疼痛属性量表和视觉模拟量表进行测量，报告的疼痛行为通过两个用于评估疼痛情境中回避和活动情况的量表进行评估。医学控制变量为晨僵以及病情活动和关节炎症的两个指标。分层回归分析表明（纳入医学变量后），影响量表（抑郁、焦虑、攻击性）对疼痛体验（形容词量表：3%）和报告的疼痛行为（回避：11%，活动：6%）变化的解释有显著贡献。当疾病活动和情绪保持不变时，IAQ对疼痛体验和疼痛行为的解释力进一步达到11 - 14%。另一方面，当医学变量和非理性态度得到控制时，情绪与疼痛之间未表现出共同变化。根据我们的研究结果，认知概念似乎比情感结构在解释疼痛体验和疼痛行为方面更具影响力。文中还讨论了对心理疼痛治疗研究与实践的启示。
