乐观和心理弹性与成人膝骨关节炎或有患病风险者的临床和实验性疼痛测量指标呈正相关。
Optimism and Psychological Resilience are Beneficially Associated With Measures of Clinical and Experimental Pain in Adults With or at Risk for Knee Osteoarthritis.
机构信息
Departments of Psychology.
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa.
出版信息
Clin J Pain. 2018 Dec;34(12):1164-1172. doi: 10.1097/AJP.0000000000000642.
OBJECTIVES
This cross-sectional study examined the associations among optimism, psychological resilience, endogenous pain inhibition, and clinical knee pain severity. Two hypotheses were tested. First, we hypothesized that experimentally tested endogenous pain inhibition would mediate the relationship between optimism and clinical knee pain severity. Second, it was also hypothesized that optimism would moderate the relationships of psychological resilience with endogenous pain inhibition and clinical knee pain severity, particularly for individuals with high optimism.
METHODS
A total of 150 individuals with or at risk for symptomatic knee osteoarthritis completed the Life Orientation Test-Revised, the Brief Resilience Scale, and the revised Short-Form McGill Pain Questionnaire-2 to assess optimism, psychological resilience, and clinical knee pain severity, respectively. Endogenous pain inhibition was examined experimentally using a conditioned pain modulation (CPM) protocol with algometry (test stimulus) and a cold pressor task (conditioning stimulus).
RESULTS
As hypothesized, results showed that increased CPM significantly mediated the association between higher optimism and lower clinical knee pain severity. Further, optimism moderated the association between psychological resilience and CPM. However, contrary to our hypothesis, greater psychological resilience was associated with enhanced CPM in individuals with low optimism only.
DISCUSSION
This study suggests that an optimistic outlook may beneficially impact clinical pain severity by altering endogenous pain modulatory capacity. Furthermore, individuals with low optimism (ie, pessimists) may be more adept at engaging resources that promote psychological resilience, which in turn, enhances endogenous pain modulatory capacity. Therefore, this study supports consideration of psychological resilience factors when evaluating experimental and clinical pain outcomes.
目的
本横断面研究探讨了乐观、心理弹性、内源性疼痛抑制与临床膝关节疼痛严重程度之间的关系。提出了两个假设。首先，我们假设经实验测试的内源性疼痛抑制将介导乐观与临床膝关节疼痛严重程度之间的关系。其次，还假设乐观将调节心理弹性与内源性疼痛抑制和临床膝关节疼痛严重程度之间的关系，特别是对于高乐观的个体。
方法
共有 150 名有或有患症状性膝骨关节炎风险的个体完成了生活取向测试修订版、简要韧性量表和修订后的短式麦吉尔疼痛问卷-2，分别评估乐观、心理弹性和临床膝关节疼痛严重程度。使用痛觉调制（CPM）方案和冷加压任务（条件刺激）进行实验性内源性疼痛抑制检查。
结果
正如假设的那样，结果表明，CPM 的增加显著介导了较高的乐观与较低的临床膝关节疼痛严重程度之间的关联。此外，乐观调节了心理弹性与 CPM 之间的关联。然而，与我们的假设相反，只有低乐观（即悲观）的个体中，更大的心理弹性与增强的 CPM 相关。
讨论
本研究表明，乐观的观点可能通过改变内源性疼痛调节能力，对临床疼痛严重程度产生有益影响。此外，低乐观（即悲观）的个体可能更善于利用促进心理弹性的资源，从而增强内源性疼痛调节能力。因此，本研究支持在评估实验和临床疼痛结果时考虑心理弹性因素。
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