运动恐惧/（再）损伤模型从灾难化开始呈顺时针方向：来自慢性非特异性下腰痛门诊患者样本的证据。
Model of Fear of Movement/(Re)injury Runs Clockwise From Catastrophizing: Evidence From a Sample of Outpatients With Chronic Nonspecific Low Back Pain.
作者信息
Monticone Marco, Arippa Federico, Frigau Luca, Foti Calogero, Ferrari Silvano, Guicciardi Marco, Rocca Barbara
机构信息
From the Department of Surgical Sciences, University of Cagliari, Cagliari, Italy (MM); Department of Medical Sciences and Public Health and Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy (FA); Department of Economics and Business Sciences, University of Cagliari, Cagliari, Italy (LF); Department of Clinical Sciences and Translational Medicine, Tor Vergata University, Rome, Italy (CF); Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy (SF); Department of Education, Psychology and Philosophy, Faculty of the Humanities, University of Cagliari, Cagliari, Italy (MG); and Department of Clinical Psychology, International Institute of Behavioural Medicine, Seville, Spain (BR).
出版信息
Am J Phys Med Rehabil. 2025 Jun 1;104(6):506-510. doi: 10.1097/PHM.0000000000002659. Epub 2025 Jan 13.
OBJECTIVE
The aim of the study is to provide evidence that catastrophizing is the primer of the cognitive-behavioral model of fear of movement/(re)injury.
DESIGN
A cross-sectional analysis of 180 outpatients with chronic nonspecific low back pain who completed the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, the Roland-Morris Disability Questionnaire, the Hospital Anxiety and Depression Scale-Depression, and a pain intensity numerical rating scale. The intercorrelations of the outcome measures were estimated using Pearson's correlation coefficient (r), and regression analyses were used to examine their predictive values by following the left side of the fear of movement/(re)injury clockwise from the Pain Catastrophizing Scale ( P = 0.05). A postdictive analysis dichotomizing the sample into high- and low-level catastrophizers evaluated the effects of addressing catastrophizing on disability and pain.
RESULTS
The intercorrelations of the Pain Catastrophizing Scale with the Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire, Hospital Anxiety and Depression Scale-Depression and numerical rating scale were respectively r = 0.59, r = 0.54, r = 0.18, and r = 0.44. Pain Catastrophizing Scale was a significant predictor of Tampa Scale of Kinesiophobia; Pain Catastrophizing Scale and Tampa Scale of Kinesiophobia significantly predicted Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale-Depression; and Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale-Depression significantly predicted numerical rating scale. The postdictive analysis showed that addressing catastrophizing reduces disability and pain experience by 14% in high-level catastrophizers and 86% in low-level catastrophizers.
CONCLUSIONS
Our findings provide evidence that catastrophizing is the primer of the fear of movement/(re)injury.
目的
本研究旨在提供证据，证明灾难化思维是运动恐惧/（再）损伤认知行为模型的起始因素。
设计
对180名慢性非特异性下腰痛门诊患者进行横断面分析，这些患者完成了疼痛灾难化量表、坦帕运动恐惧量表、罗兰-莫里斯残疾问卷、医院焦虑抑郁量表-抑郁分量表以及疼痛强度数字评定量表。使用皮尔逊相关系数（r）估计结果指标之间的相互关系，并通过从疼痛灾难化量表开始，沿运动恐惧/（再）损伤时钟的左侧顺时针方向进行回归分析，以检验它们的预测价值（P = 0.05）。一项事后分析将样本分为高灾难化者和低灾难化者，评估解决灾难化思维对残疾和疼痛的影响。
结果
疼痛灾难化量表与坦帕运动恐惧量表、罗兰-莫里斯残疾问卷、医院焦虑抑郁量表-抑郁分量表以及数字评定量表的相互关系分别为r = 0.59、r = 0.54、r = 0.18和r = 0.44。疼痛灾难化量表是坦帕运动恐惧量表的显著预测指标；疼痛灾难化量表和坦帕运动恐惧量表显著预测罗兰-莫里斯残疾问卷和医院焦虑抑郁量表-抑郁分量表；疼痛灾难化量表、坦帕运动恐惧量表、罗兰-莫里斯残疾问卷和医院焦虑抑郁量表-抑郁分量表显著预测数字评定量表。事后分析表明，解决灾难化思维可使高灾难化者的残疾和疼痛体验减少14%，低灾难化者减少86%。
结论
我们的研究结果提供了证据，证明灾难化思维是运动恐惧/（再）损伤的起始因素。
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