Hanley Marisol A, Raichle Katherine, Jensen Mark, Cardenas Diana D
Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington 98104, USA.
J Pain. 2008 Sep;9(9):863-71. doi: 10.1016/j.jpain.2008.04.008. Epub 2008 Jun 12.
The current study sought to examine how changes in pain-related beliefs and coping responses are related to changes in pain interference and psychological functioning in individuals with spinal cord injuries (SCI) and pain. To measure longitudinal changes in these variables, respondents completed a survey that included measures of pain intensity, pain interference, and psychological functioning, as well as specific psychosocial variables (pain-related beliefs, coping, and social support) and then completed the same survey 6 months later; analyses included only the individuals who reported pain at both times (n = 40). Demographic and injury-related variables were also assessed, but none were found to be significantly associated with changes in functioning. Changes in catastrophizing and belief in one's ability to control pain were each significantly associated with changes in the outcome variables: Greater pain interference and poorer psychological functioning. Changes in specific coping strategies and social support were not predictors of changes in pain, interference, or psychological functioning. These findings support a biopsychosocial model of pain in persons with SCI. Intervention studies targeting maladaptive pain-related beliefs and catastrophizing may help to identify the causal nature of these relationships and may improve multidisciplinary treatment of pain in SCI.
Intervention studies targeting catastrophizing and maladaptive pain-related beliefs may be the next step in determining which variables play a causal role in the pain interference and psychological functioning of individuals with pain and SCI.
当前研究旨在探讨脊髓损伤（SCI）且伴有疼痛的个体中，与疼痛相关的信念和应对反应的变化如何与疼痛干扰和心理功能的变化相关联。为了测量这些变量的纵向变化，受访者完成了一项调查，该调查包括疼痛强度、疼痛干扰和心理功能的测量，以及特定的社会心理变量（与疼痛相关的信念、应对方式和社会支持），然后在6个月后再次完成相同的调查；分析仅纳入了两次均报告有疼痛的个体（n = 40）。还评估了人口统计学和与损伤相关的变量，但未发现任何变量与功能变化有显著关联。灾难化思维的变化以及对自身控制疼痛能力的信念变化均与结果变量的变化显著相关：疼痛干扰加剧和心理功能较差。特定应对策略和社会支持的变化并非疼痛、干扰或心理功能变化的预测因素。这些发现支持了脊髓损伤患者疼痛的生物心理社会模型。针对适应不良的与疼痛相关的信念和灾难化思维的干预研究可能有助于确定这些关系的因果性质，并可能改善脊髓损伤疼痛的多学科治疗。
针对灾难化思维和适应不良的与疼痛相关的信念的干预研究可能是确定哪些变量在伴有疼痛和脊髓损伤的个体的疼痛干扰和心理功能中起因果作用的下一步。
