Unit for the Study and Treatment of Pain - ALGOS, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain.
Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Tarragona, Catalonia, Spain.
J Behav Med. 2018 Dec;41(6):827-835. doi: 10.1007/s10865-018-9927-6. Epub 2018 May 7.
Pain catastrophizing and pain acceptance have been shown to be associated with improvements after participation in cognitive behaviorally-based treatment (CBT) for chronic pain. However, it is not yet clear how important each of these factors is relative to the other. Furthermore, it is also not clear if multidisciplinary pain treatment has the same impact on the two primary dimensions of pain acceptance (activity engagement and pain willingness), and whether their role in explaining treatment outcome differs as a function of the outcomes under study. The aim of this study was to examine the relative importance of changes in pain catastrophizing, activity engagement and pain willingness as predictors of the benefits of a multidisciplinary CBT for chronic pain. 186 adults with chronic pain participated. Pain catastrophizing and activity engagement, but not pain willingness, were significantly associated with treatment outcome. Moreover, each one evidenced different patterns of associations with outcomes. Specifically, while changes in both were associated with improvements in depressive symptoms, only catastrophizing was associated with improvements in pain intensity and only activity engagement was associated with improvements in pain-related disability.
疼痛灾难化和疼痛接受度已被证明与参与基于认知行为的慢性疼痛治疗（CBT）后的改善有关。然而，目前尚不清楚这些因素中哪一个相对更重要。此外，还不清楚多学科疼痛治疗是否对疼痛接受度的两个主要维度（活动参与度和疼痛意愿度）产生相同的影响，以及它们在解释治疗结果方面的作用是否因研究结果而异。本研究旨在探讨疼痛灾难化、活动参与度和疼痛意愿度变化作为多学科 CBT 治疗慢性疼痛益处预测指标的相对重要性。共有 186 名慢性疼痛患者参与了研究。疼痛灾难化和活动参与度与治疗结果显著相关，但疼痛意愿度则没有。此外，每个因素都与结果存在不同的关联模式。具体而言，虽然两者的变化都与抑郁症状的改善有关，但只有灾难化与疼痛强度的改善有关，只有活动参与度与疼痛相关残疾的改善有关。
