Bradson Megan L, Cadden Margaret H, Guty Erin T, Riegler Kaitlin E, Thomas Garrett A, Graham-Engeland Jennifer E, Arnett Peter A
Department of Psychology, The Pennsylvania State University, University Park, PA, USA.
Department of Neurology, Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, MA, USA.
Arch Clin Neuropsychol. 2022 Oct 19;37(7):1515-1526. doi: 10.1093/arclin/acac025.
The present study examined coping style as a possible moderator in the relationship between pain and depression in persons with multiple sclerosis (PwMS).
Fifty-four PwMS completed a comprehensive neuropsychological test battery and psychosocial questionnaires that assessed physical, cognitive, and emotional functioning. Using four pain indices (i.e., average pain, current pain, pain intensity, and pain interference) from the Brief Pain Inventory (BPI), an overall pain index was created to capture a more comprehensive index of individuals' overall pain intensity and interference. The COPE questionnaire was used to derive three coping indices: active coping, avoidant coping, and a composite cope index that accounts for the relative contributions of both active and avoidant coping. The Beck Depression Inventory-Fast Screen (BDI-FS) was used to measure depressive symptomatology. A series of hierarchical linear regressions were conducted with depressive symptoms as the outcome variable.
Regression analyses revealed that the interactions between overall pain and each conceptualization of coping were significant (p = .001-.003). Simple effects tests revealed that overall pain only predicted depressive symptoms in PwMS with low active coping (p < .001), high avoidant coping (p < .001), and less adaptive coping via the composite coping index (p < .001).
We found that pain predicted depressive symptoms in PwMS who utilized more avoidant and less active coping strategies. Interventions aimed to improve coping style may be effective in enhancing the ability to manage pain and, subsequently, improve depression outcomes in MS.
本研究考察应对方式是否为多发性硬化症患者（PwMS）疼痛与抑郁关系中的潜在调节因素。
54名PwMS完成了一套全面的神经心理测试组和心理社会调查问卷，这些问卷评估了身体、认知和情绪功能。利用简短疼痛问卷（BPI）中的四个疼痛指标（即平均疼痛、当前疼痛、疼痛强度和疼痛干扰），创建了一个总体疼痛指数，以更全面地反映个体的总体疼痛强度和干扰情况。应对方式问卷用于得出三个应对指标：积极应对、回避应对以及一个综合应对指标，该指标考虑了积极应对和回避应对的相对作用。贝克抑郁量表快速筛查版（BDI-FS）用于测量抑郁症状。以抑郁症状为结果变量进行了一系列分层线性回归分析。
回归分析显示，总体疼痛与每种应对概念之间的交互作用显著（p = 0.001 - 0.003）。简单效应检验显示，总体疼痛仅在积极应对水平低（p < 0.001）、回避应对水平高（p < 0.001）以及通过综合应对指标适应性应对较少（p < 0.001）的PwMS中预测抑郁症状。
我们发现，在采用更多回避应对策略和更少积极应对策略的PwMS中，疼痛可预测抑郁症状。旨在改善应对方式的干预措施可能有助于提高疼痛管理能力，进而改善MS患者的抑郁状况。
