Sturgeon John A
Department of Anesthesiology, Stanford University, Palo Alto, CA, USA.
Psychol Res Behav Manag. 2014 Apr 10;7:115-24. doi: 10.2147/PRBM.S44762. eCollection 2014.
Pain is a complex stressor that presents a significant challenge to most aspects of functioning and contributes to substantial physical, psychological, occupational, and financial cost, particularly in its chronic form. As medical intervention frequently cannot resolve pain completely, there is a need for management approaches to chronic pain, including psychological intervention. Psychotherapy for chronic pain primarily targets improvements in physical, emotional, social, and occupational functioning rather than focusing on resolution of pain itself. However, psychological therapies for chronic pain differ in their scope, duration, and goals, and thus show distinct patterns of treatment efficacy. These therapies fall into four categories: operant-behavioral therapy, cognitive-behavioral therapy, mindfulness-based therapy, and acceptance and commitment therapy. The current article explores the theoretical distinctiveness, therapeutic targets, and effectiveness of these approaches as well as mechanisms and individual differences that factor into treatment response and pain-related dysfunction and distress. Implications for future research, dissemination of treatment, and the integration of psychological principles with other treatment modalities are also discussed.
疼痛是一种复杂的应激源，对功能的大多数方面都构成重大挑战，并导致巨大的身体、心理、职业和经济成本，尤其是慢性疼痛形式。由于医学干预往往无法完全消除疼痛，因此需要针对慢性疼痛的管理方法，包括心理干预。慢性疼痛的心理治疗主要目标是改善身体、情绪、社会和职业功能，而不是专注于疼痛本身的消除。然而，慢性疼痛的心理治疗在范围、持续时间和目标上存在差异，因此显示出不同的治疗效果模式。这些疗法分为四类：操作性行为疗法、认知行为疗法、正念疗法和接纳与承诺疗法。本文探讨了这些方法的理论独特性、治疗目标和有效性，以及影响治疗反应、疼痛相关功能障碍和痛苦的机制和个体差异。还讨论了对未来研究、治疗传播以及心理原则与其他治疗方式整合的影响。
