Laboratory of Neuroimmunopathology, Institute of General Pathology and Pathophysiology, Russian Academy of Sciences, 8 Baltiyskaia ul., Moscow, 125315, Russia.
University of Jaén Hospital, FIBAO, Jaén, Spain.
Sci Rep. 2021 Oct 13;11(1):20297. doi: 10.1038/s41598-021-99803-x.
A lack of personalized approaches in non-medication pain management has prevented these alternative forms of treatment from achieving the desired efficacy. One hundred and ten female patients with fibromyalgia syndrome (FMS) and 60 healthy women without chronic pain were assessed for severity of chronic or retrospective occasional pain, respectively, along with alexithymia, depression, anxiety, coping strategies, and personality traits. All analyses were conducted following a 'resource matching' hypothesis predicting that to be effective, a behavioral coping mechanism diverting or producing cognitive resources should correspond to particular mechanisms regulating pain severity in the patient. Moderated mediation analysis found that extraverts could effectively cope with chronic pain and avoid the use of medications for pain and mood management by lowering depressive symptoms through the use of distraction mechanism as a habitual ('out-of-touch-with-reality') behavior. However, introverts could effectively cope with chronic pain and avoid the use of medications by lowering catastrophizing through the use of distraction mechanism as a situational ('in-touch-with-reality') behavior. Thus, personalized behavior management techniques applied according to a mechanism of capturing or diverting the main individual 'resource' of the pain experience from its 'feeding' to supporting another activity may increase efficacy in the reduction of pain severity along with decreasing the need for pain relief and mood-stabilizing medications.
非药物性疼痛管理中缺乏个性化方法,这阻碍了这些替代治疗方法达到预期的疗效。分别对 110 名纤维肌痛综合征(FMS)女性患者和 60 名无慢性疼痛的健康女性进行了慢性或回顾性偶发性疼痛严重程度的评估,以及述情障碍、抑郁、焦虑、应对策略和人格特征的评估。所有分析均遵循“资源匹配”假设进行,该假设预测,为了达到有效治疗,转移或产生认知资源的行为应对机制应与调节患者疼痛严重程度的特定机制相对应。中介调节分析发现,外向者可以通过使用分心机制(习惯性的“脱离现实”行为)来降低抑郁症状,从而有效地应对慢性疼痛并避免使用药物来管理疼痛和情绪。然而,内向者可以通过使用分心机制(情境性的“接触现实”行为)来有效地应对慢性疼痛并避免使用药物来降低灾难化。因此,根据捕获或转移疼痛体验主要个体“资源”的机制,应用个性化行为管理技术,使其从“喂养”转向支持其他活动,可能会增加减轻疼痛严重程度的疗效,同时减少对疼痛缓解和情绪稳定药物的需求。