Paré Catherine, Yamada Keiko, Sullivan Michael J L
Department of Psychology, McGill University, Montréal, QC, Canada.
Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Clin J Pain. 2024 Jan 1;40(1):10-17. doi: 10.1097/AJP.0000000000001168.
Pain catastrophizing has been shown to be a prognostic indicator for pain severity and the co-occurrence of mental health conditions such as depression and post-traumatic stress disorder after whiplash injury. However, the pattern of available findings is limited in its implications for the possible "antecedent" or "causal" role of pain catastrophizing. The purpose of the present study was to examine the temporal relations between pain catastrophizing, pain severity, depressive symptoms, and post-traumatic stress symptoms (PTSS) in individuals receiving treatment for whiplash injury.
The sample consisted of 388 individuals enrolled in a multidisciplinary program for whiplash injury. Participants completed self-report measures of pain catastrophizing, pain severity, depressive symptoms, and PTSS at the time of admission, mid-treatment (4 week), and treatment completion (7 week). A cross-lagged panel analysis was used to examine the temporal relations between pain catastrophizing, pain severity, depressive symptoms, and PTSS across all 3 timepoints.
Model fit was acceptable after the inclusion of modification indices. Pain catastrophizing at the time of admission predicted all other variables at 4 weeks. Pain catastrophizing at 4 weeks also predicted all other variables at 7 weeks. In addition, some bidirectional relations were present, particularly for variables assessed at week 4 and week 7.
Findings support the view that pain catastrophizing might play a transdiagnostic role in the onset and maintenance of health and mental health conditions. The findings call for greater emphasis on the development of treatment techniques that target pain catastrophizing in intervention programs for whiplash injury.
疼痛灾难化已被证明是疼痛严重程度以及鞭打损伤后心理健康状况（如抑郁和创伤后应激障碍）共现情况的一个预后指标。然而，现有研究结果的模式在其对疼痛灾难化可能的“先行”或“因果”作用的影响方面存在局限性。本研究的目的是探讨接受鞭打损伤治疗的个体中疼痛灾难化、疼痛严重程度、抑郁症状和创伤后应激症状（PTSS）之间的时间关系。
样本包括388名参加鞭打损伤多学科治疗项目的个体。参与者在入院时、治疗中期（4周）和治疗结束时（7周）完成了关于疼痛灾难化、疼痛严重程度、抑郁症状和PTSS的自我报告测量。采用交叉滞后组分析来检验所有3个时间点上疼痛灾难化、疼痛严重程度、抑郁症状和PTSS之间的时间关系。
纳入修正指数后，模型拟合度可接受。入院时的疼痛灾难化预测了4周时的所有其他变量。4周时的疼痛灾难化也预测了7周时的所有其他变量。此外，还存在一些双向关系，特别是在4周和7周评估的变量之间。
研究结果支持这样一种观点，即疼痛灾难化可能在健康和心理健康状况的发生和维持中发挥跨诊断作用。这些结果呼吁在鞭打损伤干预项目中更加重视针对疼痛灾难化的治疗技术的开发。
