Cognitive-Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK.
Clin Psychol Psychother. 2019 Sep;26(5):616-625. doi: 10.1002/cpp.2386. Epub 2019 Jul 9.
This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.
(a) 探究慢性疼痛 (CP) 女性个体在疼痛强度、功能障碍、认知融合和抑郁症状方面的差异；(b) 纵向测试认知融合是否是抑郁症状的一个重要预测因素，同时控制疼痛强度和功能障碍，在 12 个月的时间内。本研究采用纵向设计，在 86 名慢性疼痛女性样本中进行，这些女性在三个同等间隔的评估时刻通过在线问卷回答问题。为了探索感兴趣变量的增长轨迹，对潜在增长曲线模型进行了检验。此外，还对人口统计学和疾病相关变量与抑郁症状之间，以及所有评估时刻的所有变量之间进行了相关性分析。认知融合和功能障碍（但不是疼痛强度）与抑郁症状的基线水平显著相关。认知融合显著预测了抑郁症状的增长轨迹，而疼痛强度和功能障碍则没有。没有人口统计学（年龄、婚姻状况、教育、社会经济）或疾病相关变量（CP 诊断次数、CP 持续时间、服用药物）在任何时候都与抑郁症状相关。这些结果表明，CP 女性抑郁症状的轨迹不是由疼痛强度或与疼痛相关的功能障碍决定的，而是由与内部体验（例如，思想、情感和身体感觉）纠缠的倾向决定的，这些体验可能与疼痛特异性内容有关，也可能无关。讨论了临床意义。
