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正念与慢性头痛/偏头痛:通过慢性疼痛的恐惧回避模型探索其机制。

Mindfulness and Chronic Headache/Migraine: Mechanisms Explored Through the Fear-Avoidance Model of Chronic Pain.

机构信息

Griffith University.

School of Applied Psychology, Menzies Health Institute, Griffith University, Qld, Australia.

出版信息

Clin J Pain. 2018 Jul;34(7):638-649. doi: 10.1097/AJP.0000000000000580.

Abstract

OBJECTIVES

To replicate a study by Schutze and colleagues on a headache sample, rather than a heterogenous chronic pain sample, investigating whether level of mindfulness predicts key components in the Fear-Avoidance Model of chronic pain (pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability); to investigate the relationships between level of mindfulness and headache/migraine pain intensity, frequency, and duration.

MATERIALS AND METHODS

Participants were 217 individuals who self-reported chronic headache/migraine (51 male, 166 female), aged between 18 and 65 years. Participants completed an online survey measuring demographics, mindfulness, the key components of the Fear-Avoidance Model, and headache pain intensity, duration, and frequency.

RESULTS

Mindfulness had significant negative correlations (P<0.05) with all variables except headache pain intensity and headache frequency. Mindfulness significantly predicted negative affect, pain catastrophizing, fear of pain, pain hypervigilance, and headache duration (P<0.05). Mindfulness remained a significant predictor of negative affect and pain hypervigilance after controlling for other key components and background characteristics (P<0.05). Mindfulness did not moderate the relationship between pain intensity and pain catastrophizing (P=0.204).

DISCUSSION

Findings suggest that mindfulness may be integrated into the Fear-Avoidance Model of chronic pain for individuals with chronic headache/migraine. Directions for future research are discussed.

摘要

目的

复制舒茨及其同事在头痛样本而非异质慢性疼痛样本上进行的一项研究,以调查正念水平是否可预测慢性疼痛的恐惧-回避模型的关键组成部分(疼痛强度、负性情绪、疼痛灾难化、与疼痛相关的恐惧、疼痛警觉过度和功能障碍);探讨正念水平与头痛/偏头痛疼痛强度、频率和持续时间之间的关系。

材料和方法

参与者为 217 名自我报告患有慢性头痛/偏头痛的个体(51 名男性,166 名女性),年龄在 18 至 65 岁之间。参与者完成了一项在线调查,调查内容包括人口统计学资料、正念、恐惧-回避模型的关键组成部分以及头痛疼痛强度、持续时间和频率。

结果

正念与除头痛疼痛强度和头痛频率之外的所有变量均呈显著负相关(P<0.05)。正念显著预测了负性情绪、疼痛灾难化、对疼痛的恐惧、疼痛警觉过度和头痛持续时间(P<0.05)。在控制其他关键组成部分和背景特征后,正念仍然是负性情绪和疼痛警觉过度的显著预测因素(P<0.05)。正念并不能调节疼痛强度与疼痛灾难化之间的关系(P=0.204)。

讨论

研究结果表明,对于患有慢性头痛/偏头痛的个体,正念可能被整合到慢性疼痛的恐惧-回避模型中。讨论了未来研究的方向。

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