Department of Counseling Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Department of Psychology, Keimyung University, Daegu, South Korea.
J Clin Psychol. 2022 Nov;78(11):2341-2356. doi: 10.1002/jclp.23425. Epub 2022 Jul 26.
Despite the critical role social and cultural contexts play in pain experience, limited theoretical and empirical attention has been devoted to the interplay between social, cognitive, cultural, and psychological factors in chronic pain management and the risk of opioid misuse.
Using structural equation modeling, the present study tested the Social Cognitive Theory (SCT) of chronic pain management and risk of opioid misuse in the context of intraindividual cultural dimensions of individualism and collectivism among 316 ethnically diverse adults with chronic pain in the United States.
Social cognitive predictors account for a significant amount of variance in pain dysfunction and risk of opioid misuse in adults with chronic pain. Satisfaction with pain support was positively associated with both greater pain acceptance and greater pain self-efficacy. Individualism was found to be positively associated with satisfaction with pain support, pain self-efficacy, and pain acceptance but negatively associated with the risk of opioid misuse. Collectivism was positively associated with the risk of opioid misuse.
The study findings not only empirically support using SCT for adults with chronic pain, but also provide a more thorough conceptual framework that highlights the intracultural diversity and interplay among social, cognitive, and psychological factors that affect pain experience and the risk of opioid misuse among adults with chronic pain.
尽管社会和文化背景在疼痛体验中起着至关重要的作用，但在慢性疼痛管理和阿片类药物滥用风险中，社会、认知、文化和心理因素之间的相互作用以及个体文化维度（个人主义和集体主义）的理论和实证关注有限。
本研究使用结构方程模型，在美国 316 名患有慢性疼痛的种族多样化成年人中，检验了慢性疼痛管理的社会认知理论（SCT）和个体文化维度（个人主义和集体主义）中的阿片类药物滥用风险。
社会认知预测因素可以解释慢性疼痛成年人中疼痛功能障碍和阿片类药物滥用风险的很大一部分变异。对疼痛支持的满意度与更大的疼痛接受度和更大的疼痛自我效能感呈正相关。个人主义与对疼痛支持、疼痛自我效能感和疼痛接受度呈正相关，但与阿片类药物滥用风险呈负相关。集体主义与阿片类药物滥用风险呈正相关。
研究结果不仅在实证上支持将 SCT 用于慢性疼痛成年人，而且还提供了一个更全面的概念框架，强调了社会、认知和心理因素之间的内在文化多样性和相互作用，这些因素影响着慢性疼痛成年人的疼痛体验和阿片类药物滥用风险。
