Mun Chung Jung, Karoly Paul, Okun Morris A
Department of Psychology, Arizona State University, Tempe, AZ, USA.
Pain. 2015 Nov;156(11):2276-2285. doi: 10.1097/j.pain.0000000000000278.
Multilevel modeling was used to examine the effects of morning pain intensity and morning positive and negative affect on pain's interference with afternoon work goal pursuit and with evening work goal progress in a community sample of 132 adults who completed a 21-day diary. The moderating effects of pain acceptance and pain catastrophizing on the associations between morning pain intensity and afternoon work goal interference were also tested. Results revealed that the positive relationship between morning pain intensity and pain's interference with work goal pursuit was significantly moderated by pain acceptance, but not by pain catastrophizing. Both morning pain intensity and positive affect exerted significant indirect effects on evening work goal progress through the perception of pain's interference with work goal pursuit in the afternoon. Furthermore, the mediated effect of morning pain on evening work goal progress was significant when pain acceptance was at the grand mean and 1 SD below the grand mean, but not when pain acceptance was 1 SD above the grand mean. Thus, it appears that high pain acceptance significantly attenuates pain's capacity to disrupt work goal pursuit. Moreover, morning positive affect appears to operate as a protective factor. Additional interpretations and potential explanations for some inconsistent outcomes are discussed along with limitations, clinical implications, and suggestions for future studies.
采用多层次模型，在一个由132名成年人组成的社区样本中，考察早晨疼痛强度、早晨积极和消极情绪对疼痛干扰下午工作目标追求以及晚上工作目标进展的影响，这些成年人完成了一份为期21天的日记。还测试了疼痛接纳和灾难化思维对早晨疼痛强度与下午工作目标干扰之间关联的调节作用。结果显示，早晨疼痛强度与疼痛对工作目标追求的干扰之间的正相关关系，受到疼痛接纳的显著调节，但未受到灾难化思维的调节。早晨疼痛强度和积极情绪都通过下午对疼痛干扰工作目标追求的感知，对晚上工作目标进展产生显著的间接影响。此外，当疼痛接纳处于总体均值以及低于总体均值1个标准差时，早晨疼痛对晚上工作目标进展的中介效应显著，但当疼痛接纳高于总体均值1个标准差时则不显著。因此，似乎较高的疼痛接纳能显著减弱疼痛干扰工作目标追求的能力。此外，早晨积极情绪似乎起到了保护因素的作用。文中还讨论了对一些不一致结果的其他解释和潜在原因，以及局限性、临床意义和对未来研究的建议。
