McCracken L M, Gross R T, Aikens J, Carnrike C L
Department of Psychiatry, University of Chicago, IL 60637, USA.
Behav Res Ther. 1996 Nov-Dec;34(11-12):927-33. doi: 10.1016/s0005-7967(96)00057-5.
Instruments used to study anxiety and fear responses related to chronic pain vary along two dimensions. They differ in terms of the stimuli or situations that evoke anxiety responses and the types of anxiety responses included (i.e. cognitive, motoric, and physiological). This study examined relations of variables from the Pain Anxiety Symptoms Scale (PASS), the Fear-Avoidance Beliefs Questionnaire (FABQ), the Fear of Pain Questionnaire (FPQ), and the trait version of the Spielberger State-Trait Anxiety Inventory (STAI) with variables related to pain severity, perceived disability, and pain behavior. Subjects were 45 consecutive referrals to a university pain clinic who completed these measures during their evaluation. Results suggested that anxiety responses directly related to the patient's particular pain sensations are more relevant to the understanding of chronic pain than are more general tendencies to respond anxiously or fear more varied pain stimuli. Regression analyses showed that empirically selected subsets of the anxiety variables predict from 16 to 54% of the variance in pain severity, disability and pain behavior. Also, assessment of multiple anxiety response types appears useful for understanding pain behavior and disability. Further study of fear and anxiety responses of persons with pain is likely to benefit from careful selection of measures dependent on the stimulus and response dimensions assessed.
用于研究与慢性疼痛相关的焦虑和恐惧反应的仪器在两个维度上存在差异。它们在引发焦虑反应的刺激或情境以及所包含的焦虑反应类型（即认知、运动和生理）方面有所不同。本研究考察了疼痛焦虑症状量表（PASS）、恐惧回避信念问卷（FABQ）、疼痛恐惧问卷（FPQ）以及斯皮尔伯格状态-特质焦虑量表（STAI）特质版中的变量与疼痛严重程度、感知到的残疾以及疼痛行为相关变量之间的关系。研究对象是连续45名被转介到大学疼痛诊所的患者，他们在评估期间完成了这些测量。结果表明，与患者特定疼痛感觉直接相关的焦虑反应，比更普遍的焦虑反应倾向或对更多样化疼痛刺激的恐惧，对于理解慢性疼痛更为相关。回归分析表明，经实证选择的焦虑变量子集可预测疼痛严重程度、残疾和疼痛行为中16%至54%的方差。此外，对多种焦虑反应类型的评估似乎有助于理解疼痛行为和残疾。对疼痛患者的恐惧和焦虑反应进行进一步研究，可能会受益于根据所评估的刺激和反应维度仔细选择测量方法。
