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基于正念的认知疗法对慢性疼痛合并抑郁症患者身体觉知的影响。

Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression.

作者信息

de Jong Marasha, Lazar Sara W, Hug Kiran, Mehling Wolf E, Hölzel Britta K, Sack Alexander T, Peeters Frenk, Ashih Heidi, Mischoulon David, Gard Tim

机构信息

Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA; Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands; MondriaanMaastricht, Netherlands.

Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA.

出版信息

Front Psychol. 2016 Jun 30;7:967. doi: 10.3389/fpsyg.2016.00967. eCollection 2016.

Abstract

Body awareness has been proposed as one of the major mechanisms of mindfulness interventions, and it has been shown that chronic pain and depression are associated with decreased levels of body awareness. We investigated the effect of Mindfulness-Based Cognitive Therapy (MBCT) on body awareness in patients with chronic pain and comorbid active depression compared to treatment as usual (TAU; N = 31). Body awareness was measured by a subset of the Multidimensional Assessment of Interoceptive Awareness (MAIA) scales deemed most relevant for the population. These included: Noticing, Not-Distracting, Attention Regulation, Emotional Awareness, and Self-Regulation. In addition, pain catastrophizing was measured by the Pain Catastrophizing Scale (PCS). These scales had adequate to high internal consistency in the current sample. Depression severity was measured by the Quick Inventory of Depressive Symptomatology-Clinician rated (QIDS-C16). Increases in the MBCT group were significantly greater than in the TAU group on the "Self-Regulation" and "Not Distracting" scales. Furthermore, the positive effect of MBCT on depression severity was mediated by "Not Distracting." These findings provide preliminary evidence that a mindfulness-based intervention may increase facets of body awareness as assessed with the MAIA in a population of pain patients with depression. Furthermore, they are consistent with a long hypothesized mechanism for mindfulness and emphasize the clinical relevance of body awareness.

摘要

身体觉察已被提出是正念干预的主要机制之一,并且已有研究表明慢性疼痛和抑郁与身体觉察水平降低有关。我们调查了基于正念的认知疗法(MBCT)对慢性疼痛合并活动性抑郁患者身体觉察的影响,并与常规治疗(TAU;N = 31)进行比较。身体觉察通过多维内感受觉察评估(MAIA)量表中被认为与该人群最相关的一个子集进行测量。这些量表包括:注意、不分心、注意力调节、情绪觉察和自我调节。此外,疼痛灾难化通过疼痛灾难化量表(PCS)进行测量。这些量表在当前样本中具有足够高的内部一致性。抑郁严重程度通过临床医生评定的抑郁症状快速清单(QIDS-C16)进行测量。在“自我调节”和“不分心”量表上,MBCT组的增加显著大于TAU组。此外,MBCT对抑郁严重程度的积极影响通过“不分心”介导。这些发现提供了初步证据,表明基于正念的干预可能会增加使用MAIA评估的疼痛合并抑郁患者群体的身体觉察方面。此外,它们与长期以来假设的正念机制一致,并强调了身体觉察的临床相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/414f/4927571/da200eda891b/fpsyg-07-00967-g0001.jpg

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