Weickgenant Anne L, Slater Mark A, Patterson Thomas L, Atkinson Hampton J, Grant Igor, Garfin Steven R
Departments of Psychiatry and Orthopedic Surgery, School of Medicine, University of California at San Diego, University of California at San Diego/San Diego State University Joint Doctoral Program in Clinical Psychology, and the Psychology, Psychiatry, and Surgery Services, San Diego Veterans Affairs Medical Center, San Diego, CA 92161 USA.
Pain. 1993 Apr;53(1):95-103. doi: 10.1016/0304-3959(93)90061-S.
To help clarify the nature of coping activities in chronic pain, this study compared how depressed (n = 37) and non-depressed (n = 40) chronic low back pain (CLBP) patients attempted to cope with pain-specific and general non-pain life stressors, relative to matched healthy control subjects (n = 40). We hypothesized that depressed mood, rather than pain alone, would account for differences in coping activities between groups. Specifically, we expected that depressed CLBP patients would report a greater proportion of passive and avoidant coping responses and less active problem solving coping attempts than non-depressed patients and controls. Results indicated that depressed CLBP patients reported more passive-avoidant coping activities than did non-depressed CLBP patients and controls, whereas coping responses were similar for non-depressed CLBP patients and controls. Additionally, subjects across groups tended to report more passive-avoidant coping in response to the specific back pain stressor (i.e., exacerbation of back pain during activity) than to other life stressors. Finally, the magnitude of reported differences in coping attempts across groups varied as a function of the type of stressor (i.e., specific back pain stressor vs. general stressful life events), particularly with regard to a disinclination to seek social support in response to the back pain exacerbation. We conclude that: (1) chronic back pain patients may employ different coping activities when attempting to manage pain exacerbations than when confronting more general life stressors, and (2) an increased rate of passive-avoidant coping responses (relative to matched health controls) is associated with the combination of CLBP and concurrent depressed mood, rather than with CLBP alone.(ABSTRACT TRUNCATED AT 250 WORDS)
为了帮助阐明慢性疼痛中应对活动的本质，本研究比较了抑郁的慢性下腰痛（CLBP）患者（n = 37）和非抑郁的慢性下腰痛患者（n = 40）相对于匹配的健康对照受试者（n = 40），是如何尝试应对疼痛特异性和一般非疼痛生活应激源的。我们假设，抑郁情绪而非单纯的疼痛，会导致各组在应对活动上存在差异。具体而言，我们预期抑郁的CLBP患者会比非抑郁患者及对照组报告更多的被动和回避性应对反应，而积极解决问题的应对尝试则更少。结果表明，抑郁的CLBP患者比非抑郁的CLBP患者及对照组报告了更多的被动-回避性应对活动，而非抑郁的CLBP患者和对照组的应对反应相似。此外，各组受试者在应对特定的背痛应激源（即活动期间背痛加剧）时，往往比应对其他生活应激源报告更多的被动-回避性应对。最后，各组在应对尝试上报告的差异程度因应激源类型（即特定背痛应激源与一般应激性生活事件）而异，尤其是在因背痛加剧而不愿寻求社会支持方面。我们得出结论：（1）慢性背痛患者在试图应对疼痛加剧时可能采用与应对更一般生活应激源时不同的应对活动；（2）被动-回避性应对反应率增加（相对于匹配的健康对照）与CLBP和并发的抑郁情绪有关，而非仅与CLBP有关。（摘要截断于250字）
