年轻人的认知融合与疼痛体验

Cognitive Fusion and Pain Experience in Young People.

作者信息

Solé Ester, Tomé-Pires Catarina, de la Vega Rocío, Racine Mélanie, Castarlenas Elena, Jensen Mark P, Miró Jordi

机构信息

*Unit for the Study and Treatment of Pain-ALGOS †Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona ‡Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain §Lawson Health Research Institute ∥Beryl & Richard Ivey Rheumatology Day Programs, St. Joseph's Health Care ¶Clinical and Neurological Sciences Department, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada #Department of Rehabilitation Medicine, University of Washington, Seattle, WA.

出版信息

Clin J Pain. 2016 Jul;32(7):602-8. doi: 10.1097/AJP.0000000000000227.

DOI:10.1097/AJP.0000000000000227

PMID:25803755

Abstract

OBJECTIVES

Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for chronic pain in young people. Cognitive fusion is a key concept of ACT that is hypothesized to contribute to distress and suffering. In this study, we sought to: (1) test hypothesized associations between cognitive fusion and pain intensity, disability, and catastrophizing; and (2) examine the function of cognitive fusion as a possible mediator between catastrophizing and disability.

METHODS

A community sample of 281 young people (11 to 20 y) completed measures assessing cognitive fusion, pain intensity, disability, and pain catastrophizing.

RESULTS

Cognitive fusion was positively related to pain intensity (r=0.24, P<0.01), disability (r=0.32, P<0.001), and pain catastrophizing (r=0.47, P<0.001). Moreover, cognitive fusion was found to mediate the association between pain catastrophizing and disability (β=0.01, 95% confidence interval=0.002-0.024, 5000 bootstrap resamples).

DISCUSSION

The findings indicate that cognitive fusion is moderately to strongly associated with pain-related outcomes, which support the need for further research to (1) better understand the relationship between cognitive fusion and adjustment to chronic pain, and (2) determine whether the benefits of treatments such as ACT are mediated, at least in part, by reductions in cognitive fusion.

摘要

目的

接纳与承诺疗法（ACT）已被证明是治疗青少年慢性疼痛的有效方法。认知融合是ACT的一个关键概念，据推测它会导致痛苦和折磨。在本研究中，我们旨在：（1）检验认知融合与疼痛强度、残疾及灾难化思维之间的假设关联；（2）考察认知融合作为灾难化思维与残疾之间可能的中介变量的作用。

方法

对281名青少年（11至20岁）的社区样本进行测量，评估认知融合、疼痛强度、残疾及疼痛灾难化思维。

结果

认知融合与疼痛强度（r = 0.24，P < 0.01）、残疾（r = 0.32，P < 0.001）及疼痛灾难化思维（r = 0.47，P < 0.001）呈正相关。此外，发现认知融合在疼痛灾难化思维与残疾之间起中介作用（β = 0.01，95%置信区间 = 0.002 - 0.024，5000次自抽样重测）。