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情境与特质测量灾难化:在多个样本中与疼痛反应的关联。

Situational versus dispositional measurement of catastrophizing: associations with pain responses in multiple samples.

机构信息

The Johns Hopkins University School of Medicine, Department of Psychiatry & Behavioral Sciences, Baltimore, MD 21287-7101, USA.

出版信息

J Pain. 2010 May;11(5):443-453.e2. doi: 10.1016/j.jpain.2009.08.009.

Abstract

UNLABELLED

Catastrophizing is widely recognized as an important risk factor for adverse pain-related outcomes. However, questions remain surrounding the details of its assessment. In particular, recent laboratory studies suggest that evaluation of "situational" catastrophizing (ie, catastrophizing measured during or directly after the administration of noxious stimulation) may provide information distinct from that obtained by standard, or "dispositional" measures, which assess individuals' recall of catastrophizing in daily life. However, comparatively little research has systematically investigated the interrelationships and properties of these 2 different forms of pain-related catastrophizing. The current study evaluated both situational and dispositional catastrophizing measures within multiple samples: healthy individuals (N = 84), patients with painful temporomandibular joint disorders (TMD; N = 48), and patients with painful arthritis (N = 43). All participants first completed the Pain Catastrophizing Scale (PCS), and then underwent psychophysical pain testing, which included heat, cold, and pressure pain. Participants then completed a situational catastrophizing measure with reference to the laboratory pain he/she had just undergone. Situational catastrophizing scores were not significantly correlated with dispositional PCS scores in the healthy participants and arthritis patients, though they were associated in TMD patients. Situational catastrophizing was more strongly associated with experimental pain responses than dispositional PCS scores for the healthy subjects and arthritis patients. In general, higher levels of situational catastrophizing were associated with lower pain thresholds and higher pain ratings across all 3 samples. The findings highlight the importance of multidimensional assessment of pain-related catastrophizing, and suggests a role for measuring catastrophizing related to specific, definable events.

PERSPECTIVE

This study adds to a growing literature examining catastrophizing. Our findings highlight the potential importance of the multidimensional assessment of pain-related catastrophizing, and suggest a role for measuring catastrophizing related to specific, definable events.

摘要

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灾难化被广泛认为是不良疼痛相关结果的重要风险因素。然而,围绕其评估细节仍存在一些问题。特别是,最近的实验室研究表明,评估“情境”灾难化(即在给予有害刺激期间或之后直接测量的灾难化)可能提供与通过标准(即,评估个体在日常生活中对灾难化的回忆的“特质”措施)获得的信息不同的信息。然而,相对较少的研究系统地调查了这两种不同形式的与疼痛相关的灾难化之间的相互关系和特性。本研究在多个样本中评估了情境和特质灾难化测量:健康个体(N=84)、患有疼痛性颞下颌关节紊乱(TMD;N=48)的患者和患有疼痛性关节炎(N=43)的患者。所有参与者首先完成疼痛灾难化量表(PCS),然后进行心理物理疼痛测试,包括热、冷和压力疼痛。然后,参与者根据他们刚刚经历的实验室疼痛完成情境灾难化测量。在健康参与者和关节炎患者中,情境灾难化评分与特质 PCS 评分没有显著相关性,尽管在 TMD 患者中存在相关性。在健康受试者和关节炎患者中,情境灾难化与实验性疼痛反应的相关性强于特质 PCS 评分。一般来说,在所有 3 个样本中,情境灾难化水平越高,疼痛阈值越低,疼痛评分越高。研究结果强调了多维评估与疼痛相关的灾难化的重要性,并表明测量与特定、可定义事件相关的灾难化的作用。

观点

本研究增加了对灾难化的研究。我们的研究结果强调了多维评估与疼痛相关的灾难化的潜在重要性,并表明测量与特定、可定义事件相关的灾难化的作用。

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