Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.
Pain. 2018 Feb;159(2):342-350. doi: 10.1097/j.pain.0000000000001102.
Chronic pain is associated with elevated negative emotions, and resources needed to adaptively regulate these emotions can be depleted during prolonged pain. Studies of links between pain, function, and negative emotions in people with chronic pain, however, have focused almost exclusively on relationships among mean levels of these factors. Indexes that may reflect aspects of emotion regulation have typically not been analyzed. We propose that 1 index of emotion regulation is variability in emotion over time as opposed to average emotion over time. The sample was 105 people with chronic low back pain and 105 of their pain-free spouses. They completed electronic diary measures 5x/d for 14 consecutive days, producing 70 observations per person from which we derived estimates of within-subject variance in negative emotions. Location-scale models were used to simultaneously model predictors of both mean level and variance in patient negative emotions over time. Patients reported significantly more variability in negative emotions compared to their spouses. Patients who reported higher average levels of pain, pain interference, and downtime reported significantly higher levels of variability in negative emotions. Spouse-observed pain and pain behaviors were also associated with greater variability in patients' negative emotions. Test of the inverse associations between negative emotion level and variability in pain and function were significant but weaker in magnitude. These findings support the notion that chronic pain may erode negative emotion regulation resources, to the potential detriment of intra- and inter-personal function.
慢性疼痛与负面情绪升高有关，而在长期疼痛期间，适应调节这些情绪所需的资源可能会被耗尽。然而，关于慢性疼痛患者的疼痛、功能和负面情绪之间联系的研究几乎完全集中在这些因素的平均水平之间的关系上。反映情绪调节方面的指数通常未进行分析。我们提出，情绪调节的一个指数是情绪随时间的变化，而不是随时间的平均情绪。样本包括 105 名慢性腰痛患者和 105 名无疼痛的配偶。他们连续 14 天每天完成 5 次电子日记测量，每人产生 70 个观察值，从中我们得出了患者负面情绪随时间变化的个体内方差估计值。位置-尺度模型用于同时对患者负面情绪的平均水平和随时间变化的方差的预测因素进行建模。与配偶相比，患者的负面情绪变化明显更大。报告平均疼痛水平、疼痛干扰和停机时间较高的患者，其负面情绪的变化幅度明显更高。配偶观察到的疼痛和疼痛行为也与患者负面情绪的更大变化相关。负面情绪水平与疼痛和功能变化之间的负相关检验具有统计学意义，但程度较弱。这些发现支持了慢性疼痛可能会侵蚀负面情绪调节资源的观点，这可能会对个体内部和个体之间的功能造成潜在的损害。
