Kröner-Herwig Birgit, Gorbunova Anastasia, Maas Jennifer
Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany.
Adolesc Health Med Ther. 2017 Mar 28;8:31-39. doi: 10.2147/AHMT.S127501. eCollection 2017.
The aim of the current study was to identify predictors of recurrent headache and back pain in young adults (aged 18-27 years) from data assessed in childhood or adolescence, i.e., 9 years before the final survey. Our interest was whether psychological characteristics contribute to the risk of pain prevalence in adult age when controlling for already empirically supported risk factors such as parental pain, pediatric pain and sex. The study was part of a five-wave epidemiological investigation of >5000 families with children aged between 7 and 14 years when addressed first. In a multiple hierarchical regression analysis, the abovementioned three variables (Block-I variables) were entered first followed by five psychological trait variables (Block-II variables: internalizing, anxiety sensitivity, somatosensory amplification, catastrophizing and dysfunctional stress coping) to find out the extent of model improvement. The multivariable hierarchical regression analysis confirmed the hypothesis that the Block-I variables significantly enhance the risk of future pain at young adult age. None of the psychological variables did so. Thus, the hypothesis of a significant surplus predictive effect was not confirmed. The amount of total explained variance differed strongly between headache and back pain. In particular, a valid prediction of back pain was not possible. When analyzed separately in simple regression analysis, psychological variables turned out to be significant predictors, however, of very low effect size. The inclusion of Block-I variables in the model clearly reduced the impact of the psychological variables. This risk profile is discussed in the context of the different trajectories of headache and back pain from childhood to adult age, which were proposed by various studies. We propose that a biopsychological characteristic denoted as emotional negativity, especially regarding self-reference, might be a common factor behind all selected variables. Risk research in recurrent pain is a field where much more multidisciplinary research is needed before progress can be expected.
本研究的目的是从童年或青少年时期（即最终调查前9年）评估的数据中，识别18至27岁年轻成年人复发性头痛和背痛的预测因素。我们感兴趣的是，在控制诸如父母疼痛、儿童疼痛和性别等已得到实证支持的风险因素时，心理特征是否会导致成年后患疼痛的风险增加。该研究是一项对5000多个有7至14岁孩子家庭进行的五波流行病学调查的一部分，最初进行调查时这些孩子处于该年龄段。在多元分层回归分析中，首先纳入上述三个变量（第一组变量），随后纳入五个心理特质变量（第二组变量：内化、焦虑敏感性、体感放大、灾难化和功能失调的压力应对），以了解模型改进的程度。多元分层回归分析证实了这一假设，即第一组变量显著增加了年轻成年人未来患疼痛的风险。心理变量则不然。因此，未证实存在显著额外预测效应的假设。头痛和背痛的总解释方差量差异很大。特别是，无法对背痛进行有效的预测。在简单回归分析中单独分析时，心理变量结果是显著的预测因素，然而效应量非常低。在模型中纳入第一组变量明显降低了心理变量的影响。在各种研究提出的从童年到成年的头痛和背痛不同轨迹的背景下，讨论了这种风险概况。我们提出，一种被称为情绪消极性的生物心理特征，尤其是关于自我参照的情绪消极性，可能是所有选定变量背后的一个共同因素。复发性疼痛的风险研究是一个在取得进展之前需要更多多学科研究的领域。
