Sündermann Oliver, Rydberg Karin, Linder Ludwig, Linton Steven James
Department of Psychology, National University of Singapore, 02-24, 9 Arts Link, 117570 Singapore, Singapore.
Department of Law, Psychology and Social Work, Center for Health and Medical Psychology (CHAMP), Örebro University, Örebro, Sweden.
Scand J Pain. 2018 Jul 26;18(3):379-388. doi: 10.1515/sjpain-2017-0163.
Background and aims Persistent pain is a pervasive condition that is often associated with a distorted body image. Most research into pain and body image investigated neural or physiological correlates (e.g. phantom limb pain), and much less is known about the psychological experience of body image changes in response to pain such as appearance concerns. The aim was to examine body image concerns in people with persistent pain, in particular appearance concerns and related coping behaviours and appearance-related emotions such as anger and shame. Methods Design was cross-sectional and data was collected through in-depth semi-structured interviews with people suffering from persistent musculoskeletal pain (n=7; six females; age=19-56), and analysed with inductive thematic analysis (TA). Results Two main themes were identified: "Relationship to the painful body" and "Dissatisfaction with the body", each containing three subthemes, along with the side-theme "Appearance concerns affected by pain and mood". All participants reported appearance concerns, predominantly about their weight and related coping behaviours such as avoidance of mirrors, exercising or dieting and pain-induced mood changes that were associated with a negative body image. Conclusions People with persistent pain report appearance concerns, often related to pain-induced negative mood changes, and reduced functioning. It remains unclear to what extent attitudes towards the body change over time in accordance with pain. A wider concept of body image is required, including the perception of reduced functioning, related appraisals (e.g. "I look weak and old") and appearance investment.
背景与目的 持续性疼痛是一种普遍存在的状况，常与身体意象扭曲相关。大多数关于疼痛与身体意象的研究探讨的是神经或生理关联（如幻肢痛），而对于因疼痛导致的身体意象变化的心理体验，如外表担忧，了解得则少得多。本研究旨在调查持续性疼痛患者的身体意象担忧，尤其是外表担忧、相关应对行为以及与外表相关的情绪，如愤怒和羞耻。方法 采用横断面设计，通过对患有持续性肌肉骨骼疼痛的患者（n = 7；6名女性；年龄19 - 56岁）进行深入的半结构化访谈收集数据，并采用归纳主题分析法进行分析。结果 确定了两个主要主题：“与疼痛身体的关系”和“对身体的不满”，每个主题包含三个子主题，以及副主题“受疼痛和情绪影响的外表担忧”。所有参与者均报告了外表担忧，主要是关于体重以及相关应对行为，如避免照镜子、锻炼或节食，以及与负面身体意象相关的疼痛引发的情绪变化。结论 持续性疼痛患者报告存在外表担忧，通常与疼痛引发的负面情绪变化和功能减退有关。目前尚不清楚对身体的态度会在多大程度上随着时间根据疼痛而改变。需要一个更宽泛的身体意象概念，包括对功能减退的认知、相关评价（如“我看起来虚弱又苍老”）以及外表投入。
