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多发性硬化症患者的神经性疼痛、认知融合和述情障碍:焦虑症状解释模型的横断面证据

Neuropathic pain, cognitive fusion, and alexithymia in patients with multiple sclerosis: Cross-sectional evidence for an explanatory model of anxiety symptoms.

作者信息

Carvalho Teresa, Gomes Carolina, Rodrigues Adriana, da Motta Carolina

机构信息

Instituto Superior Miguel Torga, Coimbra, Portugal.

Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.

出版信息

J Clin Psychol. 2023 May;79(5):1342-1356. doi: 10.1002/jclp.23483. Epub 2023 Jan 18.

DOI:10.1002/jclp.23483
PMID:36651192
Abstract

UNLABELLED

Multiple sclerosis (MS) presents a high prevalence, a marked increase worldwide, and a relevant impact on patients, public health, and society. Anxiety often cooccurs with MS and can contribute to the worsening of MS symptoms. However, knowledge about predictors of anxiety in Patients with MS (PwMS) is scarce.

OBJECTIVE

This preliminary study explored a novel model for anxiety symptoms in PwMS, including neuropathic pain (NeP), cognitive fusion (CF), experiential avoidance (EA), and alexithymia as explanatory factors.

METHOD

This cross-sectional study integrated two independent convenience samples: 107 PwMS recruited from the Portuguese Society for Multiple Sclerosis and 97 age- and gender-matched participants without the MS diagnosis (no-MS sample) recruited from the Portuguese general population. Self-report questionnaires that measured the constructs included in the model were administered to both groups.

RESULTS

PwMS showed significantly higher values regarding anxiety symptoms and their explanatory variables (NeP, CF, EA, alexithymia) in comparison to non-MS participants. In the MS sample, no correlations were found between anxiety symptoms and sociodemographic and clinical characteristics. NeP, CF, and alexithymia showed significant correlations with anxiety symptoms and significantly explained this symptomatology in simple linear regression models. Thus, these variables were retained in the multiple linear regression model and emerged as significant regressors that together explained 38% of the variance in anxious symptomatology in PwMS.

CONCLUSIONS

This preliminary study provides novel evidence on NeP and some maladaptive emotion regulation strategies related to EA/psychological inflexibility, as vulnerability to anxiety in PwMS can be considerably increased by CF and alexithymia. Clinical implications were discussed.

摘要

未标注

多发性硬化症(MS)在全球范围内患病率很高且呈显著上升趋势,对患者、公共卫生和社会都有重大影响。焦虑常常与MS同时出现,并且会导致MS症状恶化。然而,关于MS患者(PwMS)焦虑预测因素的知识却很匮乏。

目的

本初步研究探索了一种针对PwMS焦虑症状的新模型,将神经性疼痛(NeP)、认知融合(CF)、经验性回避(EA)和述情障碍作为解释因素。

方法

这项横断面研究整合了两个独立的便利样本:从葡萄牙多发性硬化症协会招募的107名PwMS患者,以及从葡萄牙普通人群中招募的97名年龄和性别匹配但未诊断为MS的参与者(非MS样本)。对两组均进行了测量模型中各结构的自我报告问卷。

结果

与非MS参与者相比,PwMS在焦虑症状及其解释变量(NeP、CF、EA、述情障碍)方面的值显著更高。在MS样本中,未发现焦虑症状与社会人口统计学和临床特征之间存在相关性。NeP、CF和述情障碍与焦虑症状显著相关,并在简单线性回归模型中显著解释了这种症状表现。因此,这些变量被保留在多元线性回归模型中,并成为显著的回归变量,共同解释了PwMS焦虑症状38%的方差。

结论

本初步研究为NeP以及与EA/心理僵化相关的一些适应不良情绪调节策略提供了新证据,因为CF和述情障碍会显著增加PwMS的焦虑易感性。文中讨论了临床意义。

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