Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States.
Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States.
J Psychosom Res. 2021 Aug;147:110527. doi: 10.1016/j.jpsychores.2021.110527. Epub 2021 May 24.
Chronic pain is conceptualized as a biopsychosocial phenomenon that involves both physical and emotional processes. The vast majority of research regarding these facets of chronic pain characterizes differences between individuals. In this review, we describe problems with assuming that differences between persons accurately characterize within-person processes. We also provide a systematic review of studies that have examined within-person relationships between pain and affect among individuals with chronic pain.
Articles published by December 2020 that pertained to within-person assessment of pain and emotion, affect, or mood were identified. Data regarding study design, adherence, and concurrent and prospective relationships among pain and affect variables were extracted and summarized.
Of 611 abstracts, 55 studies met inclusion criteria. Results suggest that individuals with chronic pain tend to experience increased negative affect and decreased positive affect when experiencing more severe pain (r = .18 and - .19, respectively). However, the size of these effects appeared smaller than between-person associations, and there was evidence of significant variability between individuals. Examination of predictive relationships between pain and affect largely suggested the tendency of symptoms to predict themselves, rather than pain predicting affect or vice versa.
Consistent with group-level relationships, experiencing more severe pain relative to an individual's average seems to be associated with more negative affect and less positive affect. However, individuals vary in the size and even direction of these effects. More research is necessary to understand the implications of such variability for the assessment and treatment of chronic pain.
慢性疼痛被视为一种涉及身体和情感过程的生物心理社会现象。绝大多数关于慢性疼痛这些方面的研究都描述了个体之间的差异。在这篇综述中，我们描述了假设个体之间的差异准确地描述了个体内部过程的问题。我们还对研究个体慢性疼痛患者疼痛与情感之间个体内关系的研究进行了系统回顾。
确定了截至 2020 年 12 月发表的与个体内疼痛和情感、情感或情绪评估相关的文章。提取并总结了有关研究设计、依从性以及疼痛和情感变量之间的同期和前瞻性关系的数据。
在 611 篇摘要中，有 55 项研究符合纳入标准。结果表明，慢性疼痛患者在经历更严重的疼痛时，往往会经历更多的负面情绪和更少的积极情绪（分别为 r =.18 和 -.19）。然而，这些影响的大小似乎小于个体间的关联，并且个体之间存在显著的变异性。对疼痛和情感之间预测关系的检查主要表明症状有自我预测的趋势，而不是疼痛预测情感或反之亦然。
与群体水平的关系一致，与个体平均水平相比，经历更严重的疼痛似乎与更多的负面情绪和更少的积极情绪相关。然而，个体在这些影响的大小甚至方向上存在差异。需要进一步研究，以了解这种变异性对慢性疼痛评估和治疗的影响。
