Osher Center for Integrative Health, Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Psychology, George Mason University, Fairfax, Virginia, USA.
Neurourol Urodyn. 2024 Nov;43(8):1895-1902. doi: 10.1002/nau.25579. Epub 2024 Sep 16.
Compensatory coping, or maladaptive alterations in behavior with the intention of preventing or managing symptoms, is increasingly being explored as a key factor in how people respond to bladder conditions. Preliminary investigations have identified relations between coping behaviors and psychological distress in urologic conditions, including interstitial cystitis/bladder pain syndrome (IC/BPS). However, previous explorations of coping have not accounted for heterogeneity in coping behaviors or addressed the likelihood that some coping behaviors may be more adaptive than others. This study sought to examine how two specific types of coping behaviors, primary control coping and disengaged coping, are related to distress and symptoms in IC/BPS, and to explore the potential role of pain phenotype in this relationship.
A secondary data analysis was conducted with a large community data set (N = 677 women with IC/BPS) and employed descriptive and inferential statistics to characterize coping patterns and explore novel predictors of distress.
Results indicated that almost all participants engaged in at least one compensatory coping behavior within the last week. Both types of coping behaviors correlated with psychological symptoms, and when controlling for relevant clinical variables (i.e., age and severity of urinary symptoms), disengaged coping behaviors were significantly associated with psychological distress. Further, the addition of pain phenotype to multiple regression models resulted in a more effective predictive model when considering the relation between coping behaviors and depression.
By investigating more deeply the relationship between coping and distress, understanding of potential risk factors and mechanisms is increased, offering valuable insights for intervention strategies for IC/BPS patients.
代偿性应对,即意图预防或管理症状而出现的行为适应性改变,正日益被视为人们对膀胱疾病反应的关键因素。初步研究已经确定了应对行为与泌尿科疾病(包括间质性膀胱炎/膀胱疼痛综合征 [IC/BPS])中的心理困扰之间的关系。然而,以前对应对的探索并未考虑应对行为的异质性,也未解决某些应对行为可能比其他行为更具适应性的可能性。本研究旨在探讨两种特定类型的应对行为,即主要控制应对和脱耦应对,与 IC/BPS 中的困扰和症状的关系,并探索疼痛表型在这种关系中的潜在作用。
对一个大型社区数据集(N=677 名 IC/BPS 女性)进行了二次数据分析,并采用描述性和推断性统计方法来描述应对模式并探索困扰的新预测因子。
结果表明,几乎所有参与者在过去一周内都至少采取了一种代偿性应对行为。这两种应对行为都与心理症状相关,当控制相关临床变量(即年龄和尿症状严重程度)时,脱耦应对行为与心理困扰显著相关。此外,当考虑应对行为与抑郁之间的关系时,将疼痛表型添加到多元回归模型中会使预测模型更加有效。
通过更深入地研究应对与困扰之间的关系,增加了对潜在风险因素和机制的理解,为 IC/BPS 患者的干预策略提供了有价值的见解。