Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
Department of Psychology, University of La Verne, La Verne, CA, USA.
Pain. 2018 Jan;159(1):25-32. doi: 10.1097/j.pain.0000000000001037.
Individuals with chronic pain may experience negative responses from spouse, family, and friends. Responses such as overt criticism and hostility may be associated with worsening pain and function for chronic pain sufferers. We used a laboratory procedure to evaluate whether variability in spouse criticism/hostility exhibited toward chronic low back pain (CLBP) patients during a conflictual discussion predicted variability in patient pain and function during a subsequent pain-induction task. Chronic low back pain patients (n = 71) and their spouses (n = 71) participated in a 10-minute discussion followed by the patient undergoing a 10-minute structured pain behavior task (SPBT). Spouse criticism/hostility perceived by patients and patient Beck Depression Inventory-II (BDI) scores correlated significantly and positively with pain intensity during the SPBT, whereas perceived spouse hostility, patient BDI scores, and spouse trait hostility correlated significantly and positively with observed pain behaviors during the SPBT. Spouse criticism/hostility coded by raters from video recordings interacted significantly with patient BDI scores, such that observed spouse criticism/hostility was related significantly and positively with pain behaviors only for patients with high BDI scores. Patient sex interacted significantly with observed spouse criticism/hostility, such that observed spouse criticism/hostility was related significantly and positively with pain behaviors only for female patients. Results support the hypothesis that spouse criticism and hostility-actually expressed or perceived-may worsen CLBP patient symptoms. Further, women patients and patients high in depressive symptoms appeared most vulnerable to spouse criticism/hostility. Thus, negative marital communication patterns may be appropriate targets for intervention, especially among these 2 at risk groups.
慢性疼痛患者可能会受到配偶、家人和朋友的负面反应。配偶的公开批评和敌意等反应可能与慢性疼痛患者的疼痛恶化和功能障碍有关。我们使用实验室程序来评估配偶在冲突讨论中对慢性下背痛（CLBP）患者的批评/敌意的变异性是否预测了患者在随后的疼痛诱发任务中的疼痛和功能的变异性。71 名慢性下背痛患者及其配偶（n=71）参加了 10 分钟的讨论，然后患者进行了 10 分钟的结构化疼痛行为任务（SPBT）。患者感知到的配偶批评/敌意和患者贝克抑郁量表第二版（BDI）分数与 SPBT 期间的疼痛强度显著正相关，而感知到的配偶敌意、患者 BDI 分数和配偶特质敌意与 SPBT 期间观察到的疼痛行为显著正相关。从视频记录中评分者编码的配偶批评/敌意与患者 BDI 分数显著交互，因此仅对于 BDI 分数高的患者，观察到的配偶批评/敌意与疼痛行为显著正相关。患者性别与观察到的配偶批评/敌意显著交互，因此仅对于女性患者，观察到的配偶批评/敌意与疼痛行为显著正相关。结果支持这样的假设，即配偶的批评和敌意——实际上表达或感知到的——可能会使 CLBP 患者的症状恶化。此外，女性患者和抑郁症状高的患者似乎最容易受到配偶批评/敌意的影响。因此，负面的婚姻沟通模式可能是干预的适当目标，尤其是在这两个高危群体中。
