Tran Patrick, Sturgeon John A, Nilakantan Aneesha, Foote Alyssa, Mackey Sean, Johnson Kevin
Department of Anesthesiology, Division of Pain Medicine, Stanford University Medical Center, Stanford, CA, USA.
Interdepartmental Neuroscience Program, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Appl Biobehav Res. 2017 Dec;22(4). doi: 10.1111/jabr.12069. Epub 2017 Apr 18.
There is an extensive relationship between chronic pain and depression; however, there is less research examining whether pain-specific factors, such as pain intensity, predict depression, above and beyond the role of normative factors, such as positive emotions. The current study characterized the independent contributions of pain intensity, pain catastrophizing, and a trait measure of happiness to self-rated depressive symptoms.
We recruited and enrolled 70 volunteers across 3 groups of participants: two groups of patients with current low back pain (one group on opioids and one group opioid-naïve), and individuals in a methadone maintenance treatment program.
Of note, participants reporting concurrent opioid use reported significantly higher levels of depressive symptomatology, although study groups did not differ on any other clinical variables. In our path model, we failed to find direct relationships between pain (intensity or duration) and either trait happiness or depressive symptoms (p > .05). However, our analysis did reveal that individuals with chronic back pain who reported higher levels of trait happiness reported lower levels of depressive symptomatology; this effect was significantly mediated by lower levels of pain catastrophizing (standardized = -.144, p = .002).
Our analysis suggests that trait happiness, while unrelated to ongoing pain, may predict a decreased vulnerability to depressive symptoms in individuals with chronic pain, which may operate via lower levels of pain catastrophizing.
慢性疼痛与抑郁之间存在广泛的关联;然而,对于疼痛特异性因素(如疼痛强度)是否能在规范因素(如积极情绪)之外预测抑郁,相关研究较少。本研究旨在探讨疼痛强度、疼痛灾难化思维以及幸福特质对自评抑郁症状的独立影响。
我们招募了70名志愿者,分为3组:两组为当前患有腰痛的患者(一组使用阿片类药物,一组未使用阿片类药物),以及一组接受美沙酮维持治疗的个体。
值得注意的是,报告同时使用阿片类药物的参与者抑郁症状水平显著更高,尽管各研究组在其他临床变量上并无差异。在我们的路径模型中,未发现疼痛(强度或持续时间)与特质幸福或抑郁症状之间存在直接关系(p >.05)。然而,我们的分析确实表明,报告特质幸福水平较高的慢性背痛个体抑郁症状水平较低;这种效应通过较低水平的疼痛灾难化思维显著介导(标准化系数 = -.144,p =.002)。
我们的分析表明,特质幸福虽然与持续疼痛无关,但可能预测慢性疼痛个体抑郁症状易感性降低,这可能通过较低水平的疼痛灾难化思维起作用。