认知行为疗法治疗慢性疼痛的结局预测因素和中介因素：心理灵活性的作用。
Predictors and mediators of outcome in cognitive behavioral therapy for chronic pain: the contributions of psychological flexibility.
机构信息
Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden.
Department of Psychology, Lund University, Lund, Sweden.
出版信息
J Behav Med. 2021 Feb;44(1):111-122. doi: 10.1007/s10865-020-00168-9. Epub 2020 Jul 8.
Abstract
There is now a consensus in the literature that future improvements in outcomes obtained from cognitive behavioral therapy (CBT) for chronic pain will require research to identify patient and treatment variables that help explain outcomes. The first aim of this study was to assess whether pre-treatment scores on measures of psychological (in)flexibility, acceptance, committed action, cognitive (de)fusion, and values-based action predict outcomes in a multidisciplinary, multicomponent, group-based CBT program for adults with chronic pain. The second aim was to assess whether change scores on these same measures mediate outcomes in the treatment program. Participants were 232 people attending treatment for chronic pain. Of the psychological flexibility measures, only pre-treatment scores on the psychological inflexibility scale predicted outcomes; higher scores on this measure were associated with worse outcomes. However, change scores on each of the psychological flexibility measures separately mediated outcomes. The efficacy of CBT for chronic pain may be improved with a greater focus on methods that increase psychological flexibility.
摘要
现在文献中有一个共识，即未来要提高认知行为疗法（CBT）治疗慢性疼痛的效果，就需要研究来确定有助于解释治疗效果的患者和治疗变量。本研究的首要目的是评估在多学科、多组分、基于小组的 CBT 方案治疗慢性疼痛的成年人中，治疗前心理（不）灵活性、接纳、承诺行动、认知（去）融合和基于价值的行动测量指标的得分是否能预测治疗效果。第二个目的是评估这些相同测量指标的变化得分是否能在治疗方案中调节治疗效果。参与者为 232 名接受慢性疼痛治疗的人。在心理灵活性测量中，只有心理不灵活性量表的治疗前得分能预测治疗效果；该指标得分越高，治疗效果越差。然而，每个心理灵活性测量指标的变化得分都分别调节了治疗效果。更加关注增加心理灵活性的方法可能会提高 CBT 治疗慢性疼痛的疗效。
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