Department of Psychology, Queen's University, Kingston, ON, Canada.
Departments of Psychology, Anesthesiology and Urology, Queen's University, Kingston, ON, Canada.
J Clin Psychol Med Settings. 2020 Mar;27(1):107-114. doi: 10.1007/s10880-019-09627-1.
Disability in inflammatory bowel disease (IBD) is under-investigated. Models theorize that disability is the result of a disease and its related impairments, limitations, and restrictions. This disablement process can be affected by psychosocial factors. Pain, depression, catastrophizing, and social support are associated with IBD-disability outcomes, but no studies have examined these factors concurrently. This study examined the role of psychosocial factors in the process of IBD disablement within the context of pain. Depressive symptoms, pain catastrophizing, and perceived social support were proposed as mediators in the relationship between pain and pain-related disability in cross-sectional and longitudinal models. Cross-sectionally, the mediation effects of depressive symptoms and pain catastrophizing, but not perceived social support, were significant. Longitudinally, depression was a significant mediator. Depressive symptoms and pain catastrophizing have mechanistic roles in the relationship between IBD patients' pain and pain-related disability and should be targets for intervention.
炎症性肠病（IBD）患者的残疾问题研究不足。有理论模型认为，残疾是疾病及其相关损伤、活动受限和社会参与受限的结果。这一致残过程可能受到心理社会因素的影响。疼痛、抑郁、灾难化思维和社会支持与 IBD 患者的残疾结局相关，但尚无研究同时探讨这些因素。本研究在疼痛背景下，考察了心理社会因素在 IBD 致残过程中的作用。抑郁症状、疼痛灾难化思维和感知社会支持被提出作为疼痛与疼痛相关残疾之间关系的中介因素，分别在横断面和纵向模型中进行检验。在横断面上，抑郁症状和疼痛灾难化思维的中介效应显著，但感知社会支持的中介效应不显著。纵向分析中，抑郁是一个显著的中介因素。抑郁症状和疼痛灾难化思维在 IBD 患者疼痛与疼痛相关残疾之间的关系中具有机制作用，应作为干预靶点。
