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使用基于正念的认知疗法改变原发性头痛患者与疼痛相关的认知加工:一项设有注意力安慰剂对照组的随机试验

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group.

作者信息

Namjoo Sarah, Borjali Ahmad, Seirafi Mohammadreza, Assarzadegan Farhad

机构信息

Department of Health Psychology, Faculty of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.

Department of Psychology, Allameh Tabataba'i University, Tehran, Iran.

出版信息

Anesth Pain Med. 2019 Oct 20;9(5):e91927. doi: 10.5812/aapm.91927. eCollection 2019 Oct.

Abstract

BACKGROUND

Mindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.

OBJECTIVES

Therefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.

METHODS

A clinical trial was conducted in 2017 - 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent -test and chi-square and longitudinal data were analyzed using linear mixed model analysis.

RESULTS

Statistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.

CONCLUSIONS

MBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

摘要

背景

基于正念的干预措施已被证明在管理慢性疼痛方面有效。认知因素在慢性疼痛并发症中起着重要作用,关于疼痛的负面认知内容通常是基于认知的疗法中首先针对的问题,在过去几十年中,这些疗法一直是慢性疼痛的一线治疗方法。然而,对于思考疼痛的方式或与疼痛相关的认知加工知之甚少。

目的

因此,本研究的目的是调查基于正念的认知疗法(MBCT)对原发性头痛患者疼痛相关认知加工和慢性疼痛控制的影响。

方法

2017年至2018年在德黑兰省伊玛目侯赛因医院通过目的抽样选取了85名患有一种原发性头痛的波斯语患者进行临床试验。为了测量研究变量,我们使用了简明疼痛量表(BPI)和疼痛相关认知加工问卷(PCPQ)。所有数据通过独立样本t检验和卡方检验进行分析,纵向数据使用线性混合模型分析。

结果

在疼痛强度(P < 0.001)、疼痛干扰(P < 0.001)以及包括疼痛聚焦、疼痛疏离和疼痛开放性在内的三个认知加工子量表(P < 0.001)中发现了具有统计学意义的时间×组交互作用。然而,疼痛转移的结果没有意义。

结论

MBCT对于头痛患者是一种潜在有效的方法。认知加工的调节和纠正被认为是MBCT治疗中有效的认知应对策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ba7/6925538/65a8a44b8cef/aapm-9-5-91927-i001.jpg

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