Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL USA.
Transl Behav Med. 2012 Mar;2(1):22-9. doi: 10.1007/s13142-011-0086-3.
Mechanisms underlying favorable outcomes of psychosocial interventions for chronic pain are unclear. Theory suggests changes in maladaptive cognitions represent therapeutic mechanisms specific to cognitive-behavioral therapy (CBT). We illustrate the importance of examining whether treatments work either uniquely via mechanisms specified by theory or via mechanisms common to different treatments. Secondary data analysis was conducted to examine the effects of reduction in pain catastrophizing on outcomes following CBT and Pain Education. Generally, reductions in pain catastrophizing were significantly related to outcome improvements irrespective of CBT or Pain Education condition. Results underscore the need to assess whether mechanisms presumed to operate specifically in one treatment do indeed predict outcomes and illustrate the importance of broadening the assessment of mechanisms beyond those specified by theory. Theory-specific, competing, and common mechanisms must all be assessed to determine why our treatments work.
心理社会干预慢性疼痛的有利结果的潜在机制尚不清楚。理论表明，适应不良认知的改变代表了认知行为疗法（CBT）特有的治疗机制。我们说明了检查治疗方法是否通过理论指定的机制或通过不同治疗方法共有的机制来发挥作用的重要性。进行了二次数据分析，以检验减少疼痛灾难化对 CBT 和疼痛教育后结果的影响。一般来说，无论是否接受 CBT 或疼痛教育，疼痛灾难化的减少与结果的改善显著相关。结果强调了需要评估假定在一种治疗中起作用的机制是否确实可以预测结果，并说明了超越理论指定的机制来扩大对机制的评估的重要性。必须评估理论特异性、竞争和共同机制，以确定为什么我们的治疗方法有效。
