Mandell Center for Multiple Sclerosis.
Pain Research, Informatics, Multimorbidities and Education Center.
Rehabil Psychol. 2019 Aug;64(3):269-278. doi: 10.1037/rep0000273. Epub 2019 Mar 21.
Pain has been identified as a highly prevalent and common correlate of physical and emotional dysfunction among persons with multiple sclerosis (PwMS). Yet, it remains unknown how PwMS experience the intrusiveness of pain relative to other challenges associated with living with MS. This study aimed to determine the extent to which PwMS experience pain as a particularly intrusive problem among the totality of their experience of MS-related challenges and to examine how cognitive and affective factors, including resiliency, are associated with PwMS's pain-related illness intrusiveness.
Participants (N = 161) were PwMS with at least mild pain who were recruited through the North American Research Committee on Multiple Sclerosis Registry for this cross-sectional study. Participants completed the Illness Intrusiveness Ratings Scale twice regarding their (a) MS and (b) pain. Multiple regression analyses were run to evaluate the relationship between MS- and pain-related illness intrusiveness, as well as the cognitive and affective predictors of the latter.
Controlling for level of disease severity, pain-related illness intrusiveness was a significant predictor of MS-related illness intrusiveness (p < .001). Depressive symptom severity was the strongest predictor of pain-related illness intrusiveness (p < .001), followed by pain catastrophizing (p < .001). The relationship between pain-related illness intrusiveness and pain catastrophizing was mediated (med) by coping strategies (Rmed2 = .15) and support from family and friends (Rmed2 = .07), with the latter mediating pain-related illness intrusiveness's relationship with depressive symptom severity (Rmed2 = .10). (PsycINFO Database Record (c) 2019 APA, all rights reserved).
疼痛已被确定为多发性硬化症患者（PwMS）身体和情绪功能障碍的一个高度普遍和常见的相关因素。然而，目前尚不清楚 PwMS 如何体验疼痛相对于与 MS 相关的其他挑战的侵入性。本研究旨在确定 PwMS 在多大程度上将疼痛体验为与 MS 相关挑战的总体体验中一个特别具有侵入性的问题，并探讨认知和情感因素（包括韧性）如何与 PwMS 的疼痛相关疾病的侵入性相关。
本横断面研究通过北美多发性硬化症研究委员会的注册系统招募了至少有轻度疼痛的 PwMS 作为参与者。参与者两次完成了疾病侵入性评分量表，分别评估他们的（a）多发性硬化症和（b）疼痛。进行了多元回归分析，以评估 MS 和疼痛相关疾病侵入性之间的关系，以及认知和情感预测因子对后者的关系。
在控制疾病严重程度水平的情况下，疼痛相关疾病的侵入性是 MS 相关疾病侵入性的一个显著预测因子（p <.001）。抑郁症状严重程度是疼痛相关疾病侵入性的最强预测因子（p <.001），其次是疼痛灾难化（p <.001）。疼痛相关疾病侵入性与疼痛灾难化之间的关系通过应对策略（Rmed2 =.15）和家庭及朋友的支持（Rmed2 =.07）得到中介（med），后者又介导了疼痛相关疾病侵入性与抑郁症状严重程度之间的关系（Rmed2 =.10）。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
