Pain and Psychotherapy Research Lab, Department of Clinical Psychology and Psychotherapy, University Koblenz-Landau, Landau, Germany.
Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
Eur J Pain. 2020 Nov;24(10):1902-1914. doi: 10.1002/ejp.1638. Epub 2020 Aug 20.
Self-compassion is associated with disability, pain-related anxiety as well as depression and anger in patients with chronic pain. However, the unique value of self-compassion versus other concepts such as psychological flexibility and self-esteem is unknown. The present study therefore aimed to clarify these relationships. Individuals with chronic pain (N = 872) and without chronic pain (N = 356) took part in a longitudinal study. Participants completed self-report instruments: Pain Disability Index (PDI), Pain Catastrophizing Scale (PCS), Pain Anxiety Symptom Scale (PASS-20), Patient Health Questionnaire (PHQ-9), State Trait Anger Expression Inventory (STAXI), Self-Compassion Scale (SCS), Psychological Inflexibility in Pain Scale (PIPS) and Rosenberg Self-Esteem Scale (RSES). Assessments were repeated after 8 weeks. We found differences in baseline levels of all relevant variables except for anger-out and anger-control between people with and without chronic pain. Subsequently, we computed a path model analysis regarding individuals suffering from chronic pain (N), addressing the predictive value of reduced uncompassionate self-responding (RUS), compassionate self-responding (CS), avoidance (PIPS), cognitive fusion (PIPS) and self-esteem (RSES) regarding pain-related (PDI, PCS, PASS) and emotional variables (PHQ-9, STAXI). Avoidance predicted disability, catastrophizing, anxiety and depression. RUS predicted catastrophizing and pain-related anxiety. Self-esteem predicted depression. CS and cognitive fusion had no unique predictive value. The model explained 65.4%-72.1% of the variance in pain-related variables, 68.7% of the variance in depression and 38.7%-60.7% in the variance of anger-related variables. In conclusion, psychological flexibility, in terms of avoidance, seems to be more relevant for chronic pain than self-compassion. Future research should focus on subgroups and tailored-treatment approaches. SIGNIFICANCE: Applying a longitudinal design, this study examined the predictive value of self-compassion regarding pain, depression and anger. The relevance of self-compassion was compared to psychological flexibility and self-esteem. We can conclude that psychological flexibility, in terms of avoidance behaviour, is the most relevant predictor concerning pain.
自我同情与慢性疼痛患者的残疾、与疼痛相关的焦虑以及抑郁和愤怒有关。然而，自我同情与其他概念（如心理灵活性和自尊）的独特价值尚不清楚。因此，本研究旨在阐明这些关系。患有慢性疼痛的个体（N=872）和没有慢性疼痛的个体（N=356）参加了一项纵向研究。参与者完成了自我报告的量表：疼痛残疾指数（PDI）、疼痛灾难化量表（PCS）、疼痛焦虑症状量表（PASS-20）、患者健康问卷（PHQ-9）、状态特质愤怒表达量表（STAXI）、自我同情量表（SCS）、疼痛中的心理不灵活性量表（PIPS）和罗森伯格自尊量表（RSES）。在 8 周后进行了重复评估。我们发现，除了愤怒发作和愤怒控制外，患有慢性疼痛的人和没有慢性疼痛的人在所有相关变量的基线水平上都存在差异。随后，我们针对患有慢性疼痛的个体（N）进行了路径模型分析，针对减少不宽容的自我反应（RUS）、同情的自我反应（CS）、回避（PIPS）、认知融合（PIPS）和自尊（RSES）对疼痛相关（PDI、PCS、PASS）和情绪变量（PHQ-9、STAXI）的预测价值。回避预测残疾、灾难化、焦虑和抑郁。RUS 预测灾难化和与疼痛相关的焦虑。自尊预测抑郁。CS 和认知融合没有独特的预测价值。该模型解释了疼痛相关变量 65.4%-72.1%、抑郁 68.7%和愤怒相关变量 38.7%-60.7%的方差。结论：就回避而言，心理灵活性似乎比自我同情更与慢性疼痛相关。未来的研究应该关注亚组和个体化治疗方法。意义：本研究采用纵向设计，考察了自我同情对疼痛、抑郁和愤怒的预测价值。将自我同情的相关性与心理灵活性和自尊进行了比较。我们可以得出结论，就回避行为而言，心理灵活性是与疼痛最相关的预测因素。
