Trépanier A, Turcotte S, Foldes-Busque G
École de psychologie, faculté des sciences sociales, 2325, rue des Bibliothèques, local L-042, Québec, G1V 0A6, Canada; Centre de recherche du Centre intégré de santé et de service sociaux Chaudière-Appalaches, Lévis, QC, Canada.
Centre de recherche du Centre intégré de santé et de service sociaux Chaudière-Appalaches, Lévis, QC, Canada.
Encephale. 2022 Dec;48(6):653-660. doi: 10.1016/j.encep.2021.06.022. Epub 2021 Nov 18.
Chronic pain is a highly prevalent condition that is associated with distressing somatic and emotional experiences. Consequently, an individual's distress tolerance, the perceived capacity to tolerate negative psychological and physical states, may influence their pain experience. This effect could be explained in part by a reduction in the catastrophic interpretation of pain which is associated with increased pain intensity and interference in everyday activities.
The first aim of this study was to explore the association between the components of the 5-factor model of distress tolerance and (1) pain intensity and (2) pain interference in everyday activities. The secondary aim was to assess the potential mediating effect of pain catastrophizing in the eventual association between components of distress tolerance and (1) pain intensity or (2) pain interference in everyday activities.
This is a cross-sectional study of adult (18 years or older) university students and staff with chronic pain (3 months). They were invited to complete the online questionnaire through an email invitation. Pain intensity and interference in everyday functioning were assessed with the corresponding subscales of the Brief Pain Inventory. The following instruments were used to assess the components of the 5-factor model of distress tolerance: Ambiguity Tolerance Scale (tolerance to ambiguity), Intolerance to Uncertainty Scale (reversed score: tolerance to uncertainty), Discomfort Intolerance Scale (reversed score: discomfort tolerance), Distress Tolerance Scale (tolerance to negative emotions), Frustration Discomfort Scale (tolerance to frustration). Participants also completed the Pain Catastrophizing Scale.
Eighty participants were recruited (57 % women, mean age=33.09; standard deviation=12,87). Tolerance to negative emotions was the only component of distress tolerance that was associated with pain (ß=-0.04; 95% CI): -0.07--0.01; t (78)=-3.06, p<0.01) or pain interference in everyday functioning (ß=-0.07; 95% CI: -0.10--0.03; t (78)=-3.97, p<0.01), independently of the others. Combined with age, these factors explained 16.2 % of the variance in pain intensity and 19.4 % of the variance in pain interference. Pain catastrophizing partially mediated the association between tolerance to negative emotions and pain interference in everyday functioning, but it was not involved in the association between tolerance to negative emotions and pain intensity.
Tolerance to negative emotions appears to be the most relevant aspect of distress tolerance in the context of chronic pain and is a potential clinical target that is independent and complementary from pain catastrophizing.
慢性疼痛是一种非常普遍的病症，与令人痛苦的躯体和情感体验相关。因此，个体的痛苦耐受力，即感知到的耐受负面心理和生理状态的能力，可能会影响他们的疼痛体验。这种影响部分可以通过减少对疼痛的灾难性解读来解释，而这种解读与疼痛强度增加以及日常活动受到干扰有关。
本研究的首要目的是探讨痛苦耐受力五因素模型的各组成部分与（1）疼痛强度和（2）日常活动中的疼痛干扰之间的关联。次要目的是评估疼痛灾难化在痛苦耐受力各组成部分与（1）疼痛强度或（2）日常活动中的疼痛干扰之间最终关联中的潜在中介作用。
这是一项针对患有慢性疼痛（3个月）的成年（18岁及以上）大学生和工作人员的横断面研究。通过电子邮件邀请他们完成在线问卷。使用简明疼痛量表的相应子量表评估疼痛强度和日常功能中的干扰情况。使用以下工具评估痛苦耐受力五因素模型的各组成部分：模糊耐受性量表（对模糊性的耐受性）、不确定性不耐受量表（反向计分：对不确定性的耐受性）、不适不耐受量表（反向计分：不适耐受性）、痛苦耐受力量表（对负面情绪的耐受性）、挫折不适量表（对挫折的耐受性）。参与者还完成了疼痛灾难化量表。
招募了80名参与者（57%为女性，平均年龄 = 33.09；标准差 = 12.87）。对负面情绪的耐受性是痛苦耐受力中唯一与疼痛（β = -0.04；95%置信区间：-0.07--0.01；t(78) = -3.06，p < 0.01）或日常功能中的疼痛干扰（β = -0.07；95%置信区间：-0.10--0.03；t(78) = -3.97，p < 0.01）相关的组成部分，独立于其他部分。与年龄相结合，这些因素解释了疼痛强度方差的16.2%和疼痛干扰方差的19.4%。疼痛灾难化部分介导了对负面情绪的耐受性与日常功能中疼痛干扰之间的关联，但它未参与对负面情绪的耐受性与疼痛强度之间的关联。
在慢性疼痛背景下，对负面情绪的耐受性似乎是痛苦耐受力最相关的方面，并是一个独立于疼痛灾难化且与之互补的潜在临床靶点。
