Kent Martha, Mardian Aram S, Regalado-Hustead Morgan Lee, Gress-Smith Jenna L, Ciciolla Lucia, Kim Jinah L, Scott Brandon A
Research Department, Phoenix Veterans Affairs Health Care System, Phoenix, AZ, United States.
Department of Psychology, Arizona State University, Tempe, AZ, United States.
Front Psychol. 2021 Apr 12;12:613341. doi: 10.3389/fpsyg.2021.613341. eCollection 2021.
Current treatments for chronic pain have limited benefit. We describe a resilience intervention for individuals with chronic pain which is based on a model of viewing chronic pain as dysregulated homeostasis and which seeks to restore homeostatic self-regulation using strategies exemplified by survivors of extreme environments. The intervention is expected to have broad effects on well-being and positive emotional health, to improve cognitive functions, and to reduce pain symptoms thus helping to transform the suffering of pain into self-growth. A total of 88 Veterans completed the pre-assessment and were randomly assigned to either the treatment intervention ( = 38) or control ( = 37). Fifty-eight Veterans completed pre- and post-testing (intervention = 31, control = 27). The intervention covered resilience strengths organized into four modules: (1) engagement, (2) social relatedness, (3) transformation of pain and (4) building a good life. A broad set of standardized, well validated measures were used to assess three domains of functioning: health and well-being, symptoms, and cognitive functions. Two-way Analysis of Variance was used to detect group and time differences. Broadly, results indicated significant intervention and time effects across multiple domains: (1) Pain decreased in present severity [ = 5.02, < 0.05, η = 0.08], total pain over six domains [ = 14.52, < 0.01, η = 0.21], and pain interference [ = 6.82, < 0.05, η = 0.11]; (2) Affect improved in pain-related negative affect [ = 7.44, < 0.01, η = 0.12], fear [ = 7.70, < 0.01, η = 0.12], and distress [ = 10.87, < 0.01, η = 0.16]; (3) Well-being increased in pain mobility [ = 5.45, < 0.05, η = 0.09], vitality [ = 4.54, < 0.05, η = 0.07], and emotional well-being [ = 5.53, < 0.05, η = 0.09] Mental health symptoms and the cognitive functioning domain did not reveal significant effects. This resilience intervention based on homeostatic self-regulation and survival strategies of survivors of extreme external environments may provide additional sociopsychobiological tools for treating individuals with chronic pain that may extend beyond treating pain symptoms to improving emotional well-being and self-growth. Registered with ClinicalTrials.gov (NCT04693728).
目前针对慢性疼痛的治疗效果有限。我们描述了一种针对慢性疼痛患者的复原力干预措施，该措施基于将慢性疼痛视为内稳态失调的模型，并试图通过极端环境幸存者所采用的策略来恢复内稳态自我调节。预计该干预措施将对幸福感和积极情绪健康产生广泛影响，改善认知功能，并减轻疼痛症状，从而有助于将疼痛带来的痛苦转化为自我成长。共有88名退伍军人完成了预评估，并被随机分配到治疗干预组（n = 38）或对照组（n = 37）。58名退伍军人完成了前后测试（干预组n = 31，对照组n = 27）。该干预措施涵盖了组织成四个模块的复原力优势：（1）参与度，（2）社会关联性，（3）疼痛转化，以及（4）构建美好生活。使用了一系列广泛的标准化且经过充分验证的测量方法来评估三个功能领域：健康与幸福感、症状以及认知功能。采用双向方差分析来检测组间和时间差异。总体而言，结果表明在多个领域存在显著的干预和时间效应：（1）当前疼痛严重程度降低[F(1,56) = 5.02，p < 0.05，η² = 0.08]，六个领域的总疼痛[F(1,56) = 14.52，p < 0.01，η² = 0.21]，以及疼痛干扰[F(1,56) = 6.82，p < 0.05，η² = 0.11]；（2）与疼痛相关的负面影响[F(1,56) = 7.44，p < 0.
