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感到完美的压力:对慢性疼痛青少年疼痛相关痛苦和功能障碍的影响。

Feeling the Pressure to Be Perfect: Effect on Pain-Related Distress and Dysfunction in Youth With Chronic Pain.

机构信息

Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.

Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts.

出版信息

J Pain. 2018 Apr;19(4):418-429. doi: 10.1016/j.jpain.2017.11.012. Epub 2017 Dec 14.

Abstract

UNLABELLED

Despite clinical observation of perfectionistic tendencies among youth with chronic pain and their parents as well as established relationships between perfectionism and functional somatic symptoms in adults and youth, no research in the pediatric pain literature has examined perfectionism. This study explored the role of various types of youth and parent perfectionism on youth and parent pain-related distress and behavior and youth pain-related dysfunction. At admission, 239 parent-child pairs from outpatient and day-treatment rehabilitation settings completed several questionnaires assessing perfectionism, pain-related distress, and pain-related dysfunction. Bivariate correlations indicated that socially prescribed perfectionism in youth and parents was linked to youth pain duration, parent and youth pain-related distress and behavior, and youth somatization. Indirect relations showed that youth socially prescribed perfectionism was the only form of perfectionism directly associated with youth somatization whereas all forms of youth perfectionism were indirectly associated with somatization and functional disability through increases in youth pain-related fear and catastrophizing. Additionally, socially prescribed perfectionism was the only type of parent perfectionism linked to youth pain-related dysfunction (somatization, functional disability) through its association with youth pain-related fear. Findings support clinical observations that parent and youth perfectionism is a psychosocial factor that should be targeted in pediatric chronic pain treatment.

PERSPECTIVE

Perfectionism in youth with chronic pain and their parents was indirectly linked to youth pain-related dysfunction through its effect on youth pain-related catastrophizing and fear. Findings support clinical observations that parent and youth perfectionism is a psychosocial factor that should be targeted in pediatric chronic pain treatment.

摘要

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尽管临床观察到慢性疼痛的青少年及其父母存在完美主义倾向,以及成人和青少年的完美主义与功能性躯体症状之间存在既定关系,但儿科疼痛文献中没有研究过完美主义。本研究探讨了各种类型的青少年和父母完美主义对青少年和父母与疼痛相关的痛苦和行为以及青少年与疼痛相关的功能障碍的作用。在入院时,来自门诊和日间治疗康复机构的 239 对父母-子女完成了几项评估完美主义、与疼痛相关的痛苦和疼痛相关的功能障碍的问卷。双变量相关性表明,青少年和父母的社会规定完美主义与青少年的疼痛持续时间、父母和青少年与疼痛相关的痛苦和行为以及青少年的躯体化有关。间接关系表明,青少年的社会规定完美主义是唯一与青少年躯体化直接相关的完美主义形式,而所有形式的青少年完美主义都通过增加青少年与疼痛相关的恐惧和灾难化而间接地与躯体化和功能障碍相关。此外,社会规定的完美主义是唯一一种与青少年与疼痛相关的功能障碍(躯体化、功能障碍)相关的父母完美主义形式,因为它与青少年与疼痛相关的恐惧有关。研究结果支持临床观察,即父母和青少年的完美主义是儿科慢性疼痛治疗中应针对的心理社会因素。

观点

青少年慢性疼痛及其父母的完美主义通过对青少年与疼痛相关的灾难化和恐惧的影响,间接地与青少年与疼痛相关的功能障碍有关。研究结果支持临床观察,即父母和青少年的完美主义是儿科慢性疼痛治疗中应针对的心理社会因素。

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