Department Clinical Psychological Science, Research Group Behavioral Medicine, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands Department of Psychology, Research Group Health Psychology, University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
Pain. 2011 Jun;152(6):1382-1390. doi: 10.1016/j.pain.2011.02.018. Epub 2011 Mar 9.
It has been proposed that goal pursuit plays a role in the development of chronic pain disorders. On the basis of (affective) motivational theories, it was hypothesized that both long-term achievement goals and short-term hedonic goals would be related to increased levels of pain and disability, particularly in patients with high negative affect. Participants with musculoskeletal pain complaints (N=299) completed a battery of questionnaires including a novel goal pursuit questionnaire (GPQ) measuring the extent to which participants preferred hedonic goals (mood-management or pain-avoidance goals) over achievement goals in various situations. Explorative factor analysis of the GPQ resulted in a reliable pain-avoidance (α=.88) and mood-management subscale (α=.76). A nonlinear, U-shaped relationship was found among the pain-avoidance scale (but not the mood-management scale) and pain and disability. This indicated that participants who strongly endorsed either achievement or pain-avoidance goals also reported higher pain and disability levels while controlling for biographical variables and pain catastrophizing. For pain but not disability, these relationships were only found among patients with high negative affect. For disability, goal pursuit and negative affect were independently related to disability. These findings provide support for the validity of an affective-motivational approach to chronic pain, suggesting that the experience of pain and the interference of pain on daily life activities depends on goal pursuit and negative affect. Interventions aimed at improving disability in chronic pain should address both patient's goal pursuit and negative affect. An affective-motivational approach to chronic pain indicates that achievement and pain-avoidance goals are associated with pain severity and disability, particularly in patients with high negative affect.
有人提出，目标追求在慢性疼痛障碍的发展中起作用。基于（情感）动机理论，假设长期成就目标和短期享乐目标都与更高水平的疼痛和残疾有关，尤其是在高负面情绪的患者中。有肌肉骨骼疼痛抱怨的参与者（N=299）完成了一系列问卷，包括一个新的目标追求问卷（GPQ），用于衡量参与者在各种情况下更喜欢享乐目标（情绪管理或疼痛回避目标）而不是成就目标的程度。对 GPQ 的探索性因素分析得出了可靠的疼痛回避（α=.88）和情绪管理子量表（α=.76）。在疼痛回避量表（但不是情绪管理量表）和疼痛与残疾之间发现了一种非线性的 U 形关系。这表明，强烈支持成就或疼痛回避目标的参与者也报告了更高的疼痛和残疾水平，同时控制了传记变量和疼痛灾难化。对于疼痛，但不是残疾，这些关系仅在高负面情绪的患者中发现。对于残疾，目标追求和负面情绪与残疾独立相关。这些发现为慢性疼痛的情感动机方法提供了支持，表明疼痛体验和疼痛对日常生活活动的干扰取决于目标追求和负面情绪。旨在改善慢性疼痛残疾的干预措施应同时针对患者的目标追求和负面情绪。慢性疼痛的情感动机方法表明，成就和疼痛回避目标与疼痛严重程度和残疾有关，尤其是在高负面情绪的患者中。
