William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal.
Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
Clin J Pain. 2021 May 1;37(5):339-348. doi: 10.1097/AJP.0000000000000930.
Pain catastrophizing and pain acceptance are psychological factors that have been shown to be associated with pain-related outcomes and predict multidisciplinary pain treatment outcomes. However, they are rarely examined in the same study. This study aimed to: (1) assess the independent roles of pain catastrophizingand pain acceptance as predictors of pain intensity, pain interference, and depression; and (2) evaluate the potential moderating role of pain acceptance on the association between pain catastrophizing and both pain and function.
A sample of 467 adults with chronic pain completed an online survey including measures of pain intensity, pain interference, depression, pain catastrophizing, and pain acceptance.
Pain catastrophizing and pain acceptance were independent predictors of pain interference. Only pain catastrophizing and the activity engagement domain of pain acceptance were independent predictors of pain intensity and depression. Activity engagement moderated the association between pain catastrophizing and depression, indicating a buffering effect on the negative effects of catastrophizing on depression. Pain willingness moderated the association between pain catastrophizing and pain interference, such that endorsing low pain willingness may override any negative effects of pain catastrophizing.
The findings suggest that pain catastrophizing and pain acceptance are independently important to adjustment to chronic pain. Research is needed to determine if treatments that target both for change are more effective than treatments that target only one.
疼痛灾难化和疼痛接受度是与疼痛相关结局相关，并可预测多学科疼痛治疗结局的心理因素。然而，它们在同一研究中很少被同时检查。本研究旨在：(1)评估疼痛灾难化和疼痛接受度作为疼痛强度、疼痛干扰和抑郁的预测因子的独立作用；(2)评估疼痛接受度对疼痛灾难化与疼痛和功能之间关联的潜在调节作用。
467 名慢性疼痛成年人完成了一项在线调查，包括疼痛强度、疼痛干扰、抑郁、疼痛灾难化和疼痛接受度的测量。
疼痛灾难化和疼痛接受度是疼痛干扰的独立预测因子。只有疼痛灾难化和疼痛接受度的活动参与度是疼痛强度和抑郁的独立预测因子。活动参与度调节了疼痛灾难化和抑郁之间的关联，表明对灾难化对抑郁的负面影响有缓冲作用。疼痛意愿调节了疼痛灾难化与疼痛干扰之间的关联，表明对低疼痛意愿的认可可能会抵消疼痛灾难化的任何负面影响。
研究结果表明，疼痛灾难化和疼痛接受度对慢性疼痛的适应是独立重要的。需要研究是否针对两者进行改变的治疗方法比仅针对一种治疗方法更有效。
