Linton Steven J
CHAMP (Center for Health and Medical Psychology) Department of Law, Psychology, and Social Work, Örebro University.
J Appl Biobehav Res. 2013 Jun;18(2):82-103. doi: 10.1111/jabr.12007.
Emotion and pain are known to be intimately related, but treating co-occurring problems is still in its infancy mainly because we lack a clear theoretical understanding of the underlying mechanisms involved. This lack of understanding is problematic because treatment has proved challenging and co-occurring pain and emotional problems are associated with poor outcome, relapse, and greater sick absenteeism. Transdiagnostics has emerged as one way of focusing on the shared underlying mechanisms that drive comorbid problems. This approach has not been thoroughly examined for pain and emotion. Hence, the purpose of this review is to describe a transdiagnostic approach to pain and emotion and its clinical implications. To this end, the transdiagnostic approach is applied to pain and emotion in a narrative review of the literature. A focus on the function of emotion and pain relative to the context is underscored as a way to understand the relationship better. Avoidance, catastrophic worry, and thought suppression are put forward as three examples of potential transdiagnostic mechanisms that may underlie a co-occurring emotion and pain problem. The approach is readily translated to the clinic where assessment and treatment should focus on identifying transdiagnostic mechanisms. However, additional exploration is needed and therefore suggestions for future research are presented.
众所周知,情绪与疼痛密切相关,但针对同时出现的问题进行治疗仍处于起步阶段,主要原因在于我们对其中涉及的潜在机制缺乏清晰的理论认识。这种认识上的不足存在问题,因为治疗已被证明具有挑战性,且同时出现的疼痛和情绪问题与不良预后、复发及更高的病假率相关。跨诊断学已成为一种关注驱动共病问题的共同潜在机制的方法。这种方法尚未针对疼痛和情绪进行全面研究。因此,本综述的目的是描述一种针对疼痛和情绪的跨诊断方法及其临床意义。为此,在对文献的叙述性综述中将跨诊断方法应用于疼痛和情绪。强调关注情绪和疼痛相对于情境的功能,以此作为更好地理解两者关系的一种方式。回避、灾难性担忧和思维抑制被提出作为可能是同时出现的情绪和疼痛问题潜在跨诊断机制的三个例子。该方法很容易转化到临床,在临床中评估和治疗应侧重于识别跨诊断机制。然而,仍需要进一步探索,因此给出了未来研究的建议。