Department of Psychiatry and Psychology.
University of Washington/Seattle Children's Research Institute, Seattle, Washington, USA.
Pain Med. 2018 Jan 1;19(1):60-67. doi: 10.1093/pm/pnx020.
Despite ample research documenting deficits in executive functioning for adults with chronic pain, the literature on pediatric patients with chronic pain is limited and provides mixed results. The current study sought to further investigate the nature of executive dysfunction in this population and also examine the relationships between pain intensity, duration, and catastrophizing with sustained attention, working memory, and self- and parent-report of executive functioning.
Pediatric pain clinic and rehabilitation program.
Forty adolescents with chronic pain and their parents participated in this study.
Participants completed neuropsychological measures and standardized self-report questionnaires during a 45- to 60-minute testing session.
Fifty percent of this sample of adolescents with chronic pain demonstrated significant difficulties on at least one measure, with nine participants indicating difficulties on multiple measures. Pain significantly increased during the testing session. Pain variables of intensity, duration, and catastrophizing are related to sustained attention and working memory.
This study adds support to previous findings suggesting subclinical struggles with executive functioning for adolescents with chronic pain. One-half of the sample indicated difficulties in either sustained attention and/or working memory. Future studies that would more thoroughly examine more complex executive functioning skills in this population would be helpful to further guide multidisciplinary treatment of these patients, particularly regarding whether or not school accommodations are warranted.
尽管有大量研究记录了慢性疼痛成年人的执行功能缺陷，但关于慢性疼痛儿科患者的文献有限，且结果不一。本研究旨在进一步探讨该人群执行功能障碍的性质，并研究疼痛强度、持续时间和灾难化与持续注意力、工作记忆以及自我和父母报告的执行功能之间的关系。
儿科疼痛诊所和康复计划。
40 名患有慢性疼痛的青少年及其父母参加了这项研究。
参与者在 45-60 分钟的测试过程中完成了神经心理学测试和标准化的自我报告问卷。
该慢性疼痛青少年样本中有 50%的人在至少一项测试中表现出明显的困难，9 名参与者在多项测试中表现出困难。在测试过程中疼痛明显增加。疼痛的强度、持续时间和灾难化等变量与持续注意力和工作记忆有关。
本研究进一步证实了之前的研究结果，即慢性疼痛的青少年存在亚临床的执行功能障碍。有一半的样本在持续注意力和/或工作记忆方面存在困难。未来的研究将有助于更全面地研究该人群的更复杂的执行功能技能，这将有助于为这些患者提供多学科治疗，特别是是否需要学校适应。
