Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland.
Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland.
J Pain. 2023 Apr;24(4):667-678. doi: 10.1016/j.jpain.2022.12.002. Epub 2022 Dec 8.
Difficulties with pain-specific emotion regulation (ER; eg, pain catastrophizing, pain acceptance) are associated with poor pain outcomes. Less is known about how general ER relates to pain outcomes, or the extent to which pain-specific and general ER interact. In a sample (N = 1,453) of adults with chronic pain, the current study used latent profile analysis to identify subgroups of people with distinct pain-specific and general ER profiles, and determined how subgroup membership at baseline related to pain severity, pain interference, depression and anxiety symptoms at 12-month follow-up. Four groups were identified: 1) general ER difficulties only (29.6%); 2) pain-specific and general ER difficulties (26.3%); 3) skillful pain-specific and general ER (24.6%); 4) pain-specific ER difficulties only (19.4%). Controlling for auto-correlation and demographic covariates, those with pain-specific and general ER difficulties had the worst outcomes in all domains. Membership to other groups did not differentiate between pain severity or interference outcomes; those skillful in pain-specific and general ER had the lowest depression and anxiety symptoms at 12 months. General ER difficulties are common among adults with chronic pain and raise relative risk when paired with pain-specific ER difficulties. Findings offer potential directions for individualizing pain psychology treatment. PERSPECTIVE: This article shows that people with chronic pain have different sets of strengths and difficulties when it comes to regulating emotions related and/or unrelated to the experience of pain itself. Understanding an individual's unique constellation of emotion regulation skills and difficulties might help personalize the psychological treatment of pain.
疼痛特定情绪调节(ER;例如,疼痛灾难化、疼痛接受)困难与疼痛结局不良有关。对于一般 ER 与疼痛结局的关系,以及疼痛特异性和一般 ER 的相互作用程度,了解较少。在一项患有慢性疼痛的成年人样本(N=1453)中,本研究使用潜在剖面分析来确定具有不同疼痛特异性和一般 ER 特征的人群亚组,并确定基线时的亚组成员身份与 12 个月随访时的疼痛严重程度、疼痛干扰、抑郁和焦虑症状之间的关系。确定了四个亚组:1)仅一般 ER 困难(29.6%);2)疼痛特异性和一般 ER 困难(26.3%);3)熟练的疼痛特异性和一般 ER(24.6%);4)仅疼痛特异性 ER 困难(19.4%)。控制自相关和人口统计学协变量后,那些具有疼痛特异性和一般 ER 困难的人在所有领域的结果都最差。属于其他组别的人在疼痛严重程度或干扰结果方面没有差异;那些熟练掌握疼痛特异性和一般 ER 的人在 12 个月时抑郁和焦虑症状最低。一般 ER 困难在患有慢性疼痛的成年人中很常见,并且当与疼痛特异性 ER 困难结合时会增加相对风险。研究结果为个性化疼痛心理治疗提供了潜在方向。观点:本文表明,患有慢性疼痛的人在调节与疼痛本身相关和/或不相关的情绪方面具有不同的优势和困难。了解个体独特的情绪调节技能和困难组合可能有助于个性化疼痛的心理治疗。