Rogers Andrew H, Smit Tanya, Bakhshaie Jafar, Zvolensky Michael J
Division of Behavioral Medicine, Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, 462 Grider Street, Buffalo, NY, 14215, USA.
Department of Psychology, University of Houston, Houston, TX, USA.
J Behav Med. 2025 Aug 8. doi: 10.1007/s10865-025-00590-x.
Chronic pain is a significant public health problem linked to notable functional impairment and economic burden. Despite considerable research attention, chronic pain treatments only yield small to medium sized effects for pain complaints. Better understanding the pain experience may help improve treatment outcomes for pain. Specifically, intraindividual variation in pain intensity represents a potentially important avenue that captures the dynamic nature of pain and may improve overall understanding of pain. Limited work has examined metrics of intraindividual pain variation across chronic pain populations, but no work has examined how these metrics are associated with pain functional outcomes (pain-related disability, negative affect, and activity avoidance). Therefore, the current study utilized ecological momentary assessment to assess pain intensity, pain-related disability, negative affect, and activity avoidance, 5 times a day for 7 days, among 48 adults with chronic pain. Results suggested that pain instability metrics (e.g., intraindividual standard deviation) were associated with pain-related activity avoidance, while dynamic metrics of variability (e.g. % of time in high pain) were directly associated with pain-related disability and negative affect. Results from the current study have important clinical implications that can be applied to the assessment of pain to guide further treatment planning. Contextualizing pain as a dynamic experience that can be captured via intensive self-report assessment may improve overall intervention outcomes.
慢性疼痛是一个重大的公共卫生问题，与明显的功能障碍和经济负担相关。尽管受到了大量的研究关注，但慢性疼痛治疗对疼痛主诉的效果仅为小到中等程度。更好地理解疼痛体验可能有助于改善疼痛的治疗效果。具体而言，疼痛强度的个体内差异代表了一条潜在的重要途径，它捕捉了疼痛的动态本质，并可能增进对疼痛的整体理解。有限的研究考察了慢性疼痛人群中个体内疼痛差异的指标，但尚无研究考察这些指标与疼痛功能结局（疼痛相关残疾、负面情绪和活动回避）之间的关联。因此，本研究采用生态瞬时评估法，对48名慢性疼痛成人患者进行为期7天、每天5次的疼痛强度、疼痛相关残疾、负面情绪和活动回避评估。结果表明，疼痛不稳定性指标（如个体内标准差）与疼痛相关的活动回避有关，而变异性动态指标（如处于高疼痛状态的时间百分比）与疼痛相关残疾和负面情绪直接相关。本研究结果具有重要的临床意义，可应用于疼痛评估以指导进一步的治疗计划。将疼痛视为一种可通过密集自我报告评估捕捉的动态体验，可能会改善整体干预效果。
