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焦虑敏感性与疼痛相关焦虑之间关联的本质:来自相关性研究和干预研究的证据。

The Nature of the Association between Anxiety Sensitivity and Pain-Related Anxiety: Evidence from Correlational and Intervention Studies.

作者信息

Olthuis Janine V, Watt Margo C, Mackinnon Sean P, Potter Susan M, Stewart Sherry H

机构信息

a Department of Psychology & Neuroscience , Dalhousie University , Halifax , Nova Scotia B3H 4R2 , Canada.

b Department of Psychology , Saint Francis Xavier University , Antigonish , Nova Scotia B2G 2W5 , Canada.

出版信息

Cogn Behav Ther. 2015;44(5):423-40. doi: 10.1080/16506073.2015.1048823. Epub 2015 Jun 19.

DOI:10.1080/16506073.2015.1048823
PMID:26091087
Abstract

High anxiety sensitivity (AS) has been associated with elevated pain-related anxiety in anxiety and pain samples. The present study investigated (a) the associations among the lower order dimensions of AS and pain-related anxiety, using a robust measure of AS, and (b) the pain-related anxiety outcomes of a telephone-delivered cognitive behavioural treatment (CBT) designed to reduce high AS. Participants were 80 anxiety treatment-seeking participants with high AS (M age = 36 years; 79% women). After providing baseline data on AS and pain-related anxiety, participants were randomly assigned to an eight-week telephone CBT or a waiting list control. At baseline, bivariate correlations showed AS physical and cognitive, but not social, concerns were significantly associated with pain-related fear and arousal but not escape/avoidance behaviours. Multiple regression revealed that after accounting for emotional distress symptoms, AS physical, but not cognitive or social, concerns uniquely predicted pain-related anxiety. Multilevel modelling showed that the AS-targeted CBT reduced pain-related anxiety and treatment-related changes in global AS and AS physical concerns mediated changes in pain-related anxiety. Results suggest that an AS-targeted intervention may have implications for reducing pain-related anxiety. Further research is needed in a chronic pain sample.

摘要

高焦虑敏感性(AS)与焦虑和疼痛样本中与疼痛相关的焦虑水平升高有关。本研究调查了:(a)使用一种可靠的AS测量方法,AS的低阶维度与疼痛相关焦虑之间的关联;以及(b)一种旨在降低高AS的电话认知行为疗法(CBT)的疼痛相关焦虑结果。参与者为80名寻求焦虑治疗且AS较高的参与者(年龄中位数 = 36岁;79%为女性)。在提供了关于AS和疼痛相关焦虑的基线数据后,参与者被随机分配到为期八周的电话CBT组或等待名单对照组。在基线时,双变量相关性显示,AS的身体和认知方面(而非社交方面)的担忧与疼痛相关的恐惧和唤醒显著相关,但与逃避/回避行为无关。多元回归显示,在考虑了情绪困扰症状后,AS的身体方面(而非认知或社交方面)的担忧独特地预测了疼痛相关焦虑。多层次模型显示,针对AS的CBT降低了疼痛相关焦虑,且全球AS和AS身体方面担忧的治疗相关变化介导了疼痛相关焦虑的变化。结果表明,针对AS的干预可能对降低疼痛相关焦虑有意义。在慢性疼痛样本中还需要进一步研究。

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