Ter Kuile Moniek M, Spinhoven Philip, Linssen Corry G A, van Houwelingen Hans C
Department of Psychiatry, University of Leiden, 2300 RC Leiden The Netherlands Department of Medical Statistics, University of Leiden, 2300 RC Leiden, The Netherlands.
Pain. 1996 Feb;64(2):257-264. doi: 10.1016/0304-3959(95)00135-2.
The purpose of the present study was to investigate the active cognitive ingredients of change in psychological treatments for long-term chronic headache complaints. The primary questions this study addressed were: (1) Is a cognitive self-hypnosis training which explicitly attempts to change appraisal and cognitive coping processes more effective in producing these changes than a relaxation procedure, and (2) are changes in pain appraisal and cognitive coping related to changes in pain and adjustment in the short and long term? A total of 144 patients were assigned at random to a cognitive self-hypnosis (CSH) treatment or autogenic training (AT) with a duration of 7 weeks. Measures used were: Headache Index (HI), Symptom Checklist-90 (SCL-90), Coping Strategy Questionnaire (CSQ), Multidimensional Locus of Pain Control Questionnaire (MLPC) and treatment expectations. The results indicated that patients successfully changed their use of coping strategies and pain appraisals. Cognitive therapy was more effective than relaxation training in changing the use of cognitive coping strategies which were the direct targets of treatment. However, treatment effects were only related with changes in the use of coping strategies and appraisal processes to a limited extent and the mediational role of cognitive processes in pain reduction and better adjustment was inconclusive.
本研究的目的是调查长期慢性头痛患者心理治疗中认知改变的有效成分。本研究解决的主要问题是：（1）一种明确试图改变评估和认知应对过程的认知自我催眠训练，在产生这些改变方面是否比放松程序更有效；（2）疼痛评估和认知应对的改变在短期和长期内是否与疼痛和适应的改变相关？总共144名患者被随机分配到为期7周的认知自我催眠（CSH）治疗或自生训练（AT）组。使用的测量方法包括：头痛指数（HI）、症状自评量表90（SCL-90）、应对策略问卷（CSQ）、多维疼痛控制源问卷（MLPC）和治疗期望。结果表明，患者成功改变了应对策略的使用和疼痛评估。在改变作为治疗直接目标的认知应对策略的使用方面，认知疗法比放松训练更有效。然而，治疗效果仅在有限程度上与应对策略的使用和评估过程的改变相关，并且认知过程在减轻疼痛和更好适应方面的中介作用尚无定论。
