Department of Psychology, National University of Singapore, Singapore.
Clin J Pain. 2011 Nov-Dec;27(9):769-74. doi: 10.1097/AJP.0b013e31821d8f5a.
Coping and beliefs are cornerstones to our understanding of adjustment to chronic pain. This study sought to test the hypothesis that maladaptive pain-related coping and beliefs are more strongly related to measures of patient adjustment than are adaptive coping and beliefs.
A sample of 106 veterans with mixed chronic pain diagnoses in a multidisciplinary pain treatment program were administered measures of pain beliefs and pain coping, and composite scores were computed to reflect adaptive and maladaptive responses. Correlations between the composite scores and outcomes (pain intensity, pain interference, depression) were examined. Hierarchical multiple regressions were also conducted to estimate the independent contributions of adaptive and maladaptive responses.
The maladaptive response composite score was found to be significantly related to pain interference and depression, whereas both adaptive and maladaptive response composite scores were found to be significantly related to pain intensity. The maladaptive response composite showed stronger independent associations with pain interference and depression after controlling for demographic variables, pain intensity, and adaptive responses. Contrary to expectations, only the adaptive response composite showed an independent association with pain intensity.
The findings suggest that the relative importance of adaptive versus maladaptive beliefs and coping may differ as a function of the outcome domain in question. The findings support current cognitive-behavioral interventions that focus on reducing the frequency of maladaptive coping responses and beliefs as a way to improve patient functioning.
应对和信念是我们理解慢性疼痛适应的基石。本研究旨在检验以下假设，即适应性疼痛相关应对和信念与患者适应的衡量标准比非适应性应对和信念更密切相关。
在一个多学科疼痛治疗计划中，对 106 名患有混合慢性疼痛诊断的退伍军人进行了疼痛信念和疼痛应对措施的测量，并计算了综合分数以反映适应性和非适应性反应。检查综合分数与结果（疼痛强度、疼痛干扰、抑郁）之间的相关性。还进行了分层多元回归，以估计适应性和非适应性反应的独立贡献。
发现非适应性反应综合评分与疼痛干扰和抑郁显著相关，而适应性和非适应性反应综合评分均与疼痛强度显著相关。在控制人口统计学变量、疼痛强度和适应性反应后，非适应性反应综合评分与疼痛干扰和抑郁的独立关联更强。与预期相反，只有适应性反应综合评分与疼痛强度有独立关联。
研究结果表明，适应性与非适应性信念和应对之间的相对重要性可能因所讨论的结果领域而异。这些发现支持当前的认知行为干预措施，该措施侧重于减少非适应性应对反应和信念的频率，以改善患者的功能。
