Leccese Adriana, Severo Melania, Ventriglio Antonio, Petrocchi Serena, Limone Pierpaolo, Petito Annamaria
Department of Humanistic Studies, University of Foggia, 71122 Foggia, Italy.
Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.
Healthcare (Basel). 2025 Mar 7;13(6):581. doi: 10.3390/healthcare13060581.
: Cognitive processes play a crucial role in the perception of pain. Catastrophizing, defined as a tendency to focus on a painful experience or amplify its unpleasantness, even in an anticipated form, might increase patients' negative expectations and feelings of helplessness. In fact, high levels of pain catastrophizing are associated with a reduction in resilient behaviors among patients with physical pain. The objective of the present study is to investigate the employment of psychological and psychotherapeutic interventions in patients reporting pain, focusing on their improvements in terms of resilience and catastrophizing. : This review was conducted following the PRISMA guidelines using three databases including articles published from 2006 to February 2024: PubMed, Scopus, and Web of Science. The search strategy was based on the PIO (Population, Intervention, Outcome) scheme. Following the Cochrane recommendations, quality assessment was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized studies and the Cochrane Risk of Bias for NonRandomized Studies (ROBINS-I). We included all English language studies reporting on psychological interventions in the context of pain management and related catastrophic thinking and resilience behaviors. Reviews, book chapters, editorials, conference abstracts and notes, observational studies, and non-English studies were excluded. Two independent authors were involved in the screening and data extraction phase. : A total of 10 studies were finally selected. The selected studies included five randomized controlled trials (RCTs); three single group, nonrandomized pilot trials; one single case study; and one nonrandomized pilot trial. The studies were mostly conducted in the United States (n = 7). Overall, the studies reported that psychological interventions in patients with physical pain may improve their psychological health and pain management. Reduced levels of catastrophic thinking and improved psychological resilience were found in subjects undergoing psychological treatments in most selected studies. : Further studies are needed, above all controlled trials, to confirm the impact of these interventions in improving patients' emotional and physical health in the long-term management of physical pain, improving their resilience and reducing catastrophic thinking.
认知过程在疼痛感知中起着至关重要的作用。灾难化思维被定义为一种倾向，即专注于痛苦经历或放大其不愉快程度，即使是以预期的形式，这可能会增加患者的负面期望和无助感。事实上，高水平的疼痛灾难化思维与身体疼痛患者的适应行为减少有关。本研究的目的是调查心理和心理治疗干预措施在报告疼痛的患者中的应用，重点关注他们在适应能力和灾难化思维方面的改善。
本综述遵循PRISMA指南，使用三个数据库进行，包括2006年至2024年2月发表的文章：PubMed、Scopus和科学网。检索策略基于PIO（人群、干预、结果）方案。根据Cochrane的建议，使用Cochrane偏倚风险工具（RoB 2.0）对随机研究进行质量评估，并使用非随机研究的Cochrane偏倚风险工具（ROBINS-I）进行评估。我们纳入了所有报告疼痛管理背景下心理干预以及相关灾难化思维和适应行为的英文研究。综述、书籍章节、社论、会议摘要和笔记、观察性研究以及非英文研究均被排除。两名独立作者参与了筛选和数据提取阶段。
最终共选择了10项研究。所选研究包括5项随机对照试验（RCT）；3项单组、非随机试点试验；1项单病例研究；以及1项非随机试点试验。这些研究大多在美国进行（n = 7）。总体而言，研究报告称，对身体疼痛患者的心理干预可能会改善他们的心理健康和疼痛管理。在大多数所选研究中，接受心理治疗的受试者的灾难化思维水平降低，心理适应能力得到改善。
需要进一步研究，尤其是对照试验，以证实这些干预措施在长期身体疼痛管理中对改善患者情绪和身体健康、提高他们的适应能力以及减少灾难化思维方面的影响。
