Lawson Kerry, Reesor Kenneth A, Keefe Francis J, Turner Judith A
Department of Psychology, The Rehabilitation Centre, OttawaCanada Department of Psychology, Ottawa General Hospital, OttawaCanada Duke University Medical Center, Durham, NCU.S.A. Multidisciplinary Pain Center and Departments of Psychiatry and Behavioral Sciences and Rehabilitation Medicine, University of Washington School of Medicine, St. Louis, MOU.S.A.
Pain. 1990 Nov;43(2):195-204. doi: 10.1016/0304-3959(90)91073-R.
Previous research has demonstrated a relationship between cognitive pain coping activity and adjustment in pain patients. The empirically derived dimensions of coping activity, as measured by scales from the Coping Strategy Questionnaire (CSQ), however, have varied across investigations. The purpose of this investigation was to determine both the content and number of dimensions of the CSQ and to explore the potential moderating influence that sociodemographic and patient history variables may have on the latent structure of the CSQ. A total of 620 patients from 5 different chronic pain patient samples were used to assess the generalizability of the dimensions across samples. Confirmatory factor analytic procedures identified a 3-factor solution in most of the samples that was robust across various demographic characteristics. Two factors appeared particularly robust: one reflected conscious use of cognitive coping strategies (with high loadings on ignoring pain and coping self-statements) and another reflected self-efficacy beliefs concerning pain (with high loadings on ability to control and decrease pain). A third factor, which was somewhat less stable, appeared to reflect avoidance of pain by attention to non-pain-related mental activity (with high loadings on diverting attention and praying and hoping). Scales reflecting catastrophizing cognitions and behavioral coping strategies did not consistently load on the above dimensions. Issues concerning the conceptualization and measurement of pain-related cognitive coping dimensions are discussed.
先前的研究已经证明了认知性疼痛应对活动与疼痛患者的适应之间存在关联。然而，通过应对策略问卷（CSQ）量表测量得出的应对活动的实证维度在不同研究中有所不同。本研究的目的是确定CSQ的维度内容和数量，并探讨社会人口统计学和患者病史变量可能对CSQ潜在结构产生的潜在调节影响。来自5个不同慢性疼痛患者样本的620名患者被用于评估各样本中维度的普遍性。验证性因素分析程序在大多数样本中确定了一个三因素解决方案，该方案在各种人口统计学特征中都很稳健。有两个因素显得尤为稳健：一个反映了对认知应对策略的有意识使用（在忽视疼痛和应对自我陈述方面负荷较高），另一个反映了对疼痛的自我效能信念（在控制和减轻疼痛的能力方面负荷较高）。第三个因素稳定性稍差，似乎反映了通过关注与疼痛无关的心理活动来避免疼痛（在转移注意力、祈祷和希望方面负荷较高）。反映灾难化认知和行为应对策略的量表并未始终负荷于上述维度。文中讨论了与疼痛相关认知应对维度的概念化和测量相关的问题。
