Ho Erica J, Turner Aaron P, Jensen Mark P, Day Melissa A, Ehde Dawn M, Anastas Tracy M, Williams Rhonda M
Rehabilitation Care Service, VA Puget Sound Health Care System - Seattle Division.
Department of Rehabilitation Medicine, University of Washington School of Medicine.
Rehabil Psychol. 2025 Feb;70(1):36-45. doi: 10.1037/rep0000557. Epub 2024 Mar 28.
Clinical trials often focus on symptom reduction as a primary outcome, overlooking positive psychology factors of potential importance although many individuals can and do live well with pain. The Patient-Reported Outcomes Measurement Information System (PROMIS) Psychosocial Illness Impact-Positive (PIIP) scale assesses perceptions of adaptive psychosocial functioning (e.g., coping and meaning-making) after illness onset. This study evaluated the effects of hypnosis (HYP), mindfulness meditation (MM), and pain psychoeducation (ED) on PIIP scores, using data from a completed randomized clinical trial (RCT) of complementary and integrative chronic pain interventions. We hypothesized that treatment effects on PIIP would mirror the RCT's primary pain intensity outcome, such that HYP and MM, relative to ED, would lead to greater improvements in PIIP during trial follow-up.
Our sample included 262 Veterans who completed the PROMIS PIIP Short-Form 8a at pre- and posttreatment and at 3- and 6-month follow-up. Linear regression was used to test between-group differences in PIIP at each time point, controlling for baseline PIIP, average pain intensity, and baseline perceptions of prepain psychosocial functioning.
There were no significant between-group differences in PIIP at posttreatment or 3-month follow-up. However, group differences emerged at 6-month follow-up: individuals randomized to MM and HYP showed improved PIIP relative to those randomized to ED.
Positive psychosocial outcomes are a mostly untapped territory in clinical trials of pain interventions. The present work highlights the potential benefits of including positive psychology concepts in both research and clinical contexts, emphasizing the importance of understanding human flourishing in the presence of illness and disability. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
临床试验通常将症状减轻作为主要结果,而忽视了潜在重要的积极心理因素,尽管许多人能够并且确实在疼痛中生活得很好。患者报告结果测量信息系统(PROMIS)心理社会疾病影响-积极(PIIP)量表评估疾病发作后适应性心理社会功能(如应对和意义建构)的认知。本研究利用一项已完成的补充和综合慢性疼痛干预随机临床试验(RCT)的数据,评估了催眠(HYP)、正念冥想(MM)和疼痛心理教育(ED)对PIIP分数的影响。我们假设对PIIP的治疗效果将反映RCT的主要疼痛强度结果,即相对于ED,HYP和MM在试验随访期间将导致PIIP有更大改善。
我们的样本包括262名退伍军人,他们在治疗前和治疗后以及3个月和6个月随访时完成了PROMIS PIIP简表8a。使用线性回归来测试每个时间点PIIP的组间差异,控制基线PIIP、平均疼痛强度和疼痛前心理社会功能的基线认知。
治疗后或3个月随访时PIIP的组间差异无统计学意义。然而,在6个月随访时出现了组间差异:随机分配到MM和HYP的个体相对于随机分配到ED的个体显示出PIIP改善。
积极心理社会结果在疼痛干预临床试验中大多是未开发的领域。目前的工作强调了在研究和临床环境中纳入积极心理学概念的潜在益处,强调了在疾病和残疾情况下理解人类繁荣的重要性。(PsycInfo数据库记录(c)2025 APA,保留所有权利)