Goubert L, Trompetter H
Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
Department of Psychology, Health and Technology, Center for eHealth and Wellbeing Research, University of Twente, Enschede, The Netherlands.
Eur J Pain. 2017 Sep;21(8):1301-1315. doi: 10.1002/ejp.1062. Epub 2017 Jun 2.
The primary objective of this paper is to discuss how a resilience approach to (chronic) pain may advance our current understanding of (mal)adaptation to pain. Different resilience perspectives are described, and future challenges for research, prevention and treatment of (chronic) pain are discussed. Literature searches were performed in Web of Science and PubMed to identify relevant literature on risk and resilience in the context of pain. Resilience can be best defined as the ability to restore and sustain living a fulfilling life in the presence of pain. The Psychological Flexibility Model, the Broaden-and-Build Theory, and Self-Determination Theory are described as theories that may provide insight into resilience within the context of (chronic) pain. We describe how a resilience paradigm shifts the outcomes to pursue in pain research and intervention and argue the need for including positive outcomes in addition to negative outcomes. Psychological flexibility, positive affect and basic psychological needs satisfaction are described as potentially important resilience mechanisms with the potential to target both sustainability and recovery from pain. A resilience approach to chronic pain may have important implications for the prevention and treatment of chronic pain problems, as it may give specific indications on how to empower patients to continue living a fulfilling life (in the presence of pain).
The resilience approach put forward in this review spotlights sustainability of positive outcomes (e.g. engagement in meaningful activities) in the presence of pain as an outcome to pursue beyond recovery of negative outcomes. We illuminate the evidence-base and practical application of promising resilience mechanisms (positive emotions, psychological flexibility, needs satisfaction). For this article, a commentary is available at the Wiley Online Library.
本文的主要目的是探讨采用复原力方法应对（慢性）疼痛如何能推进我们目前对疼痛（不）适应的理解。文中描述了不同的复原力观点，并讨论了（慢性）疼痛研究、预防和治疗未来面临的挑战。在科学网和PubMed中进行了文献检索，以确定疼痛背景下有关风险和复原力的相关文献。复原力可被最佳定义为在疼痛存在的情况下恢复并维持充实生活的能力。心理灵活性模型、拓展与建构理论以及自我决定理论被描述为可能有助于深入理解（慢性）疼痛背景下复原力的理论。我们描述了复原力范式如何改变疼痛研究和干预中所追求的结果，并主张除了负面结果外还需要纳入正面结果。心理灵活性、积极情绪和基本心理需求满足被描述为潜在重要的复原力机制，有可能针对疼痛的可持续性和恢复。应对慢性疼痛的复原力方法可能对慢性疼痛问题的预防和治疗具有重要意义，因为它可能就如何使患者（在疼痛存在的情况下）继续过上充实生活给出具体指示。
本综述中提出的复原力方法突出了在疼痛存在的情况下积极结果（如参与有意义的活动）的可持续性，将其作为除负面结果恢复之外要追求的结果。我们阐明了有前景的复原力机制（积极情绪、心理灵活性、需求满足）的证据基础和实际应用。针对本文，可在Wiley在线图书馆获取一篇评论。
