Chronic Pain Under Missile Attacks: Role of Pain Catastrophizing, Media, and Stress-Related Exposure
Chronic Pain Under Missile Attacks: Role of Pain Catastrophizing, Media, and Stress-Related Exposure
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DOI：
10.1037/tra0000297
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发表时间：
2018-07-01
影响因子：
6.3
通讯作者：
Shahar, Golan
中科院分区：
文献类型：
--
作者：
Noyman-Veksler, Gal;Shalev, Hadar;Shahar, Golan
目的：研究暴露于导弹攻击对患者疼痛和抑郁症状的影响，并通过疼痛相关的灾难化来调节。方法：对100名以色列慢性疼痛患者进行了军事行动“护刃”前后的评估，在此期间，数千枚导弹落在了全国各地的人口稠密地区。基线评估包括疼痛、抑郁和灾难化，战后评估包括暴露于导弹、疼痛和抑郁。结果：媒体暴露预测高灾难化水平下感觉疼痛的增加（高于平均值1个标准差；非标准化简单斜率= 0.57,p= 0.01），以及整个样本的抑郁（b = 0.61, p= 0.01）。与导弹有关的感知压力表现出预期的效果，预测抑郁症状的增加（b = 1.45, p= 0.03）。出乎意料的是，在高灾难化水平下，感知压力预示着感觉疼痛的减少（非标准化简单斜率= -0.49,p= 0.02）。结论：媒体暴露于急性应激可能使慢性疼痛患者更容易经历疼痛和抑郁症状，这取决于他们使用基于疼痛的灾难化。高度灾难化者可能更多地关注外部威胁，放大他们所经历的痛苦的感觉和情感方面。在这一人群中，感知到的压力在引发抑郁症状方面也起着重要作用。
Objective: We examined the effects of exposure to missile attacks on patients' pain and depressive symptoms, moderated by pain-related catastrophizing. Method: One-hundred Israeli chronic pain patients were assessed both prior and subsequent to military operation "Protective Edge," during which thousands of missiles landed on populated areas across the country. Baseline assessment included pain, depression, and catastrophizing, and postwar assessment tapped exposure to missiles, pain, and depression. Results: Media exposure predicted an increase in sensory pain under high levels of catastrophizing (1 SD above the mean; unstandardized simple slope = 0.57, p=.01), and depression in the entire sample (b = 0.61, p=.01). Perceived stress related to the missiles exhibited an expected effect, predicting an increase in depressive symptoms (b = 1.45, p=.03). Unexpectedly, perceived stress predicted a decrease in sensory pain under high levels of catastrophizing (unstandardized simple slope = -0.49, p=.02). Conclusions: Media exposure to acute stress may render chronic pain patients more vulnerable to experiencing pain and depressive symptoms, depending on their use of pain-based catastrophizing. High catastrophizers may attend more to outside threats, amplifying the sensory and affective aspects of pain they experience. Perceived stress also plays a significant role in eliciting depressive symptoms in this population.