Craner Julia R, Sperry Jeannie A, Evans Michele M
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Pain Med. 2016 Nov;17(11):2026-2035. doi: 10.1093/pm/pnw070. Epub 2016 May 26.
Pain catastrophizing is an important predictor of functioning and disability among individuals with chronic pain, and modification of catastrophic interpretations of pain is a proposed treatment mechanism of pain rehabilitation. The purpose of the current study is to examine the relationship between changes in catastrophic thinking and treatment outcomes for a large sample of patients with chronic pain. METHODS : 648 adult patients with chronic pain completed a 3-week intensive outpatient comprehensive pain rehabilitation program. Measures of pain severity, pain-related life interference, depression, and pain catastrophizing were completed at admission and discharge. RESULTS : Consistent with prior research, pain catastrophizing was associated with several negative pain-related outcomes. Results of a within-subjects mediational analysis indicated that pain catastrophizing not only improved during the treatment program, but also accounted for a significant portion of the variance in the reduction of pain severity, pain interference, and depression at the end of treatment. CONCLUSIONS : This study adds further support to the position that pain catastrophizing has a detrimental role in adaptation to chronic pain, and that this construct can be successfully modified in treatment to improve patient outcomes.
疼痛灾难化是慢性疼痛患者功能和残疾的重要预测指标，改变对疼痛的灾难性认知是疼痛康复的一种治疗机制。本研究的目的是检验大量慢性疼痛患者灾难性思维的变化与治疗结果之间的关系。方法：648名成年慢性疼痛患者完成了为期3周的强化门诊综合疼痛康复项目。在入院和出院时完成疼痛严重程度、疼痛相关生活干扰、抑郁和疼痛灾难化的测量。结果：与先前研究一致，疼痛灾难化与几个负面的疼痛相关结果相关。组内中介分析结果表明，疼痛灾难化不仅在治疗项目中得到改善，而且在治疗结束时疼痛严重程度、疼痛干扰和抑郁减轻的方差中占很大比例。结论：本研究进一步支持了这样一种观点，即疼痛灾难化在慢性疼痛适应中具有有害作用，并且这种结构可以在治疗中成功改变以改善患者预后。
