Universitat Jaume I, Avda. Vicent Sos Baynat s/n. 12071, Castellón de la Plana, Spain.
Universidad de Murcia, Murcia, Spain.
Health Qual Life Outcomes. 2019 Jul 22;17(1):128. doi: 10.1186/s12955-019-1182-1.
Because psychological variables are known to intercorrelate, the goal of this investigation was to compare the unique association between several well-established psychological constructs in pain research and pain-related outcomes. Sex differences are considered because pain is experienced differently across sex groups.
Participants were 456 consecutive chronic pain patients attending a tertiary pain clinic (mean age = 58.4 years, SD = 14.8, 63.6% women). The study design was cross-sectional. Psychological constructs included personality (NEO-Five Factor Inventory), irrational thinking (General Attitudes and Beliefs Scale), and coping (Social Problem Solving Inventory). Outcomes were pain severity and interference (Brief Pain Inventory) and physical, general, and mental health status (Short Form-36). To decide whether the bivariate analyses and the two-block, multivariate linear regressions for each study outcome (block 1 = age, sex, and pain severity; block 2 = psychological variables) should be conducted with the whole sample or split by sex, we first explored whether sex moderated the relationship between psychological variables and outcomes. An alpha level of 0.001 was set to reduce the risk of type I errors due to multiple comparisons.
The moderation analyses indicated no sex differences in the association between psychological variables and study outcomes (all interaction terms p > .05). Thus, further analyses were calculated with the whole sample. Specifically, the bivariate analyses revealed that psychological constructs were intercorrelated in the expected direction and mostly correlated with mental health and overall perceived health status. In the regressions, when controlling for age, sex, and pain severity, psychological factors as a block significantly increased the explained variance of physical functioning (ΔR2 = .037, p < .001), general health (ΔR2 = .138, p < .001), and mental health (ΔR2 = .362, p < .001). However, unique associations were only obtained for mental health and neuroticism (β = - 0.30, p < .001) and a negative problem orientation (β = - 0.26, p < .001).
There is redundancy in the relationship between psychological variables and pain-related outcomes and the strength of this association is highest for mental health status. The association between psychological characteristics and health outcomes was comparable for men and women, which suggests that the same therapeutic targets could be selected in psychological interventions of pain patients irrespective of sex.
由于心理变量相互关联，本研究的目的是比较疼痛研究中几个成熟的心理结构与疼痛相关结果之间的独特关联。考虑到性别差异，因为不同性别群体的疼痛体验不同。
本研究纳入了 456 名在三级疼痛诊所就诊的慢性疼痛患者（平均年龄 58.4 岁，标准差 14.8 岁，63.6%为女性）。研究设计为横断面研究。心理构念包括人格（NEO-五因素量表）、不合理思维（一般态度和信念量表）和应对方式（社会问题解决量表）。结果包括疼痛严重程度和干扰（简明疼痛量表）以及身体、一般和心理健康状况（SF-36）。为了确定是否应该对每个研究结果（第 1 块=年龄、性别和疼痛严重程度；第 2 块=心理变量）进行双变量分析和两阶段多元线性回归，是对整个样本进行，还是根据性别进行分组，我们首先探讨了心理变量与结果之间的关系是否受性别调节。由于多重比较导致的 I 型错误风险，设定了 0.001 的α水平。
调节分析表明，心理变量与研究结果之间的关系在性别上没有差异（所有交互项均 p>.05）。因此，进一步的分析是在整个样本中进行的。具体而言，双变量分析表明，心理构念按预期方向相互关联，且主要与心理健康和整体感知健康状况相关。在回归中，当控制年龄、性别和疼痛严重程度时，心理因素作为一个块显著增加了身体功能（ΔR2=0.037，p<.001）、一般健康（ΔR2=0.138，p<.001）和心理健康（ΔR2=0.362，p<.001）的解释方差。然而，仅获得了心理健康和神经质（β=-0.30，p<.001）以及消极问题取向（β=-0.26，p<.001）与心理健康之间的独特关联。
心理变量与疼痛相关结果之间存在冗余，且这种关联的强度与心理健康状况最高。心理特征与健康结果之间的关联在男性和女性中相似，这表明在选择疼痛患者的心理干预治疗目标时，可以不考虑性别。
