Resilience and Vulnerability in Individuals With Chronic Pain and Physical Disability
Resilience and Vulnerability in Individuals With Chronic Pain and Physical Disability
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DOI：
10.1037/rep0000055
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发表时间：
2016-02-01
影响因子：
2.7
通讯作者：
Ehde, Dawn M.
中科院分区：
文献类型：
--
作者：
Alschuler, Kevin N.;Kratz, Anna L.;Ehde, Dawn M.
目的：研究脆弱性和弹性因素对疼痛干扰、疼痛管理自我效能、全球心理健康和全球身体健康的独立贡献。研究方法/设计：对脊髓损伤（n = 73）、截肢（n = 33）或多发性硬化（n = 82）和慢性疼痛患者的基线数据进行二次分析，这些患者参加了一项比较2种慢性疼痛干预措施的随机对照试验。参与者完成了一系列与疼痛相关的结果，评估了心理社会资产和适应不良的认知和行为。结果如下：结果表明，脆弱性和复原力因素一起占相当大的差异，在物理结果，但没有一组因素能够作出重大贡献，超过其他。与此相反，心理健康相关的结果，结果表明，弹性因素确实作出了有意义的贡献以上和超越脆弱性因素，这表明慢性疼痛的心理体验的弹性因素的重要贡献。结论：本研究提出了一个宝贵的贡献，弹性和脆弱性因素疼痛的结果，与额外的警告，弹性因素独特的影响特定的结果，特别是那些更心理社会重点以上和超越脆弱性因素。总而言之，这突出了除了慢性疼痛患者的脆弱性因素外，还考虑弹性因素的重要性。需要更多的研究来探索其他因素，可以被认为是代表的弹性结构和更多的注意力应该集中在评估干预措施的影响，寻求建立个人的assets.Impact和ImplicationsThis是第一个研究，同时检查独立的贡献脆弱性和弹性因素疼痛相关的结果，包括复原力因素如何与适应性应对和缓冲对慢性疼痛和身体残疾患者的负面影响有关。结果表明，脆弱性和复原力因素都占了大量的差异，在物理结果，但这两组因素都不能作出有意义的贡献超过其他。相比之下，对于以心理健康为导向的结果，结果表明，韧性因素确实做出了超越脆弱性因素的有意义的贡献，这表明韧性因素对慢性疼痛的心理体验做出了重要贡献。考虑到弹性因素对疼痛相关结果的独特贡献，未来的研究必须研究如何最好地解决这些心理社会资产以及适应不良的认知和行为。
Objective: To examine the independent contributions of vulnerability and resilience factors to pain interference, self-efficacy for managing pain, global mental health, and global physical health. Research Method/Design: Secondary analysis of baseline data from individuals with a spinal cord injury (n = 73), amputation (n = 33), or multiple sclerosis (n = 82) and chronic pain who participated in a randomized controlled trial comparing 2 chronic pain interventions. Participants completed a comprehensive battery of pain-related outcomes that assessed for both psychosocial assets and maladaptive cognitions and behaviors. Results: Results suggested that vulnerability and resilience factors together account for a considerable amount of variance in the physical outcomes, but that neither set of factors was able to make a substantial contribution above and beyond the other. In contrast, for mental health related outcomes, results indicated that resilience factors did make a meaningful contribution above and beyond vulnerability factors, suggesting the important contribution of resilience factors to the psychological experience of chronic pain. Conclusions: The present study suggested a valuable contribution of both resilience and vulnerability factors to pain outcomes, with the additional caveat that resilience factors uniquely impact specific outcomes-particularly those that are more psychosocially focused-above and beyond vulnerability factors. Taken together, this highlights the importance of considering resilience factors in addition to vulnerability factors for individuals with chronic pain. Additional research is needed to explore other factors that could be considered representative of the resilience construct and more attention should be focused on evaluating the effects of interventions that seek to build an individual's assets.Impact and ImplicationsThis is the first study to simultaneously examine the independent contributions of vulnerability and resilience factors to pain-related outcomes, including how resilience factors relate to adaptive coping and buffer against negative consequences for those living with chronic pain and physical disability. Results suggested that both vulnerability and resilience factors account for a substantial amount of variance in physical outcomes, but that neither set of factors was able to make a meaningful contribution above and beyond the other. In contrast, for mental health oriented outcomes, results indicated that resilience factors did make a meaningful contribution above and beyond vulnerability factors, suggesting the important contribution of resilience factors to the psychological experience of chronic pain. Given that resilience factors make a unique contribution to pain-related outcomes, it is important for future research to examine how best to address these psychosocial assets in addition to maladaptive cognitions and behaviors.