Geisser M E, Robinson M E, Henson C D
Department of Clinical and Health Psychology, University of Florida, Gainesville.
Clin J Pain. 1994 Jun;10(2):98-106. doi: 10.1097/00002508-199406000-00003.
Some studies have found significant relations between both the factor scores and subscales of the Coping Strategies Questionnaire (CSQ) and various measures of adjustment to chronic pain. In their review of the literature on coping with chronic pain, Jensen et al. (Pain 1991;47:249-83) suggest that conceptual overlap between the subscales may inflate these observed correlations. In the present study, we examine the factor structure of the CSQ subscales which reflect coping, excluding the CSQ subscales which measure appraisal or activity. We then examine the relationship between the CSQ factors and subscales and pain adjustment, while controlling for selected variables.
One hundred fifty-two chronic pain patients were administered the CSQ. Seventy-three were also administered the Multidimensional Pain Inventory (MPI). Adjustment to chronic pain was defined based on patients' cluster membership on the MPI and responses to the Interference, Pain Severity, and Negative Affect subscales.
Tertiary care center.
Multiple regression analyses revealed that the Pain Avoidance factor was positively related to pain severity, interference, and MPI cluster membership. In addition, the catastrophizing subscale was positively related to negative affect and MPI cluster membership even when controlling for level of depression, ability to decrease pain was related to lower levels of pain severity, and ability to control pain was related to MPI cluster membership. Neither the Conscious Cognitive Coping factor nor the Increasing Activities subscale was related to the adjustment measures. Follow-up analyses revealed that the Praying/Hoping subscale appeared to account for the relationship between pain avoidance and adjustment.
The results suggest that praying/hoping and catastrophizing are related to poorer adjustment to chronic pain, that ability to control and decrease pain are related to better adjustment, and that catastrophizing appears to be a separate construct from depression. The results also suggest that the individual CSQ subscales may have greater utility in terms of examining coping, appraisals, and pain adjustment compared to the composite scores.
一些研究发现应对策略问卷（CSQ）的因子得分和分量表与慢性疼痛适应的各种测量指标之间存在显著关联。Jensen等人在其对慢性疼痛应对文献的综述中（《疼痛》，1991年；47:249 - 83）指出，分量表之间的概念重叠可能会夸大这些观察到的相关性。在本研究中，我们考察反映应对的CSQ分量表的因子结构，不包括测量评估或活动的CSQ分量表。然后，在控制选定变量的同时，考察CSQ因子和分量表与疼痛适应之间的关系。
152名慢性疼痛患者接受了CSQ测试。其中73人还接受了多维疼痛问卷（MPI）测试。根据患者在MPI上的聚类归属以及对干扰、疼痛严重程度和消极情绪分量表的回答来定义对慢性疼痛的适应情况。
三级护理中心。
多元回归分析显示，疼痛回避因子与疼痛严重程度、干扰以及MPI聚类归属呈正相关。此外，即使在控制抑郁水平的情况下，灾难化分量表仍与消极情绪和MPI聚类归属呈正相关，减轻疼痛的能力与较低的疼痛严重程度相关，控制疼痛的能力与MPI聚类归属相关。有意识认知应对因子和增加活动分量表均与适应测量指标无关。后续分析表明，祈祷/希望分量表似乎解释了疼痛回避与适应之间的关系。
结果表明，祈祷/希望和灾难化与较差的慢性疼痛适应相关，控制和减轻疼痛的能力与较好的适应相关，并且灾难化似乎是一个与抑郁不同的结构。结果还表明，与综合得分相比，单个CSQ分量表在考察应对、评估和疼痛适应方面可能具有更大的效用。
