Kadimpati Sandeep, Zale Emily L, Hooten Michael W, Ditre Joseph W, Warner David O
Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, Minnesota, United States of America.
Department of Psychology, Syracuse University, Syracuse, New York, United States of America.
PLoS One. 2015 Apr 22;10(4):e0126351. doi: 10.1371/journal.pone.0126351. eCollection 2015.
Several cognitive-affective constructs, including pain catastrophizing and pain-related anxiety, have been implicated in the onset and progression of chronic pain, and both constructs have been identified as key targets for multidisciplinary pain treatment. Both neuroticism and depression have been linked to these constructs (and to each other), but how each may contribute to the pain experience is unknown. This study tested associations between neuroticism, depression, and indices of catastrophizing and pain-related anxiety among persons seeking treatment for chronic non-malignant pain. We hypothesized, as a higher-order personality trait, neuroticism would remain uniquely associated with both pain catastrophizing and pain-related anxiety, even after accounting for current symptoms of depression. A retrospective study design assessed depression (as measured by the Centers for Epidemiologic Studies-Depression scale), neuroticism (measured with the Neuroticism-Extraversion-Openness Personality Inventory), the Pain Catastrophizing Scale, and the Pain Anxiety Symptom Score in a consecutive series of patients (n=595) admitted to a 3-week outpatient pain treatment program from March 2009 through January 2011. Hierarchical regression indicated that neuroticism was independently associated with greater pain catastrophizing and pain-related anxiety, above-and-beyond the contributions of sociodemographic characteristics, pain severity, and depression. A depression by neuroticism interaction was not observed, suggesting that associations between neuroticism and cognitive-affective pain constructs remained stable across varying levels of current depression. These findings represent an early but important step towards the clarification of complex associations between trait neuroticism, current depression, and tendencies toward catastrophic and anxiety-provoking appraisals of pain among persons seeking treatment for chronic pain.
包括疼痛灾难化和疼痛相关焦虑在内的几种认知情感结构，已被认为与慢性疼痛的发作和进展有关，并且这两种结构都已被确定为多学科疼痛治疗的关键目标。神经质和抑郁都与这些结构相关（且相互关联），但它们各自如何影响疼痛体验尚不清楚。本研究测试了寻求慢性非恶性疼痛治疗的人群中，神经质、抑郁与灾难化指标及疼痛相关焦虑之间的关联。我们假设，作为一种高阶人格特质，即使在考虑当前抑郁症状之后，神经质仍将与疼痛灾难化和疼痛相关焦虑保持独特的关联。一项回顾性研究设计，对2009年3月至2011年1月期间连续收治入一个为期3周的门诊疼痛治疗项目的一系列患者（n = 595），评估了抑郁（用流行病学研究中心抑郁量表测量）、神经质（用神经质-外向性-开放性人格量表测量）、疼痛灾难化量表和疼痛焦虑症状评分。分层回归表明，除了社会人口学特征、疼痛严重程度和抑郁的影响外，神经质与更高程度的疼痛灾难化和疼痛相关焦虑独立相关。未观察到抑郁与神经质的交互作用，这表明在不同程度的当前抑郁水平上，神经质与认知情感疼痛结构之间的关联保持稳定。这些发现代表了朝着阐明特质神经质、当前抑郁以及寻求慢性疼痛治疗的人群中对疼痛进行灾难性和焦虑引发性评估倾向之间复杂关联迈出的早期但重要的一步。
