The Role of Cognitive Content and Cognitive Processes in Chronic Pain: An Important Distinction?
The Role of Cognitive Content and Cognitive Processes in Chronic Pain: An Important Distinction?
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DOI：
10.1097/ajp.0000000000000559
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发表时间：
2018-05
期刊：
影响因子：
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通讯作者：
Burns JW
中科院分区：
文献类型：
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作者：
Jensen MP;Thorn BE;Carmody J;Keefe FJ;Burns JW
与疼痛相关的认知内容(人们对疼痛的看法)和认知过程(人们如何看待疼痛；他们如何处理与疼痛相关的想法)以及它们的交互作用被认为在患者功能中扮演着不同的角色。然而，对于将认知内容和认知过程作为不同领域进行评估是否可能或是否可行，提出了一些问题。这项研究的目的是确定似乎主要评估与疼痛相关的认知内容、认知过程以及内容和过程的指标彼此相对独立的程度，并为患者功能的预测贡献独特的差异。参加正在进行的随机对照试验的慢性下腰痛患者(N=165)在治疗前接受认知、疼痛和功能(抑郁症状和疼痛干预)的测量。分析支持了这样一种假设，即认知内容和认知过程虽然相关，但可以被评估为不同的组成部分。然而，评估认知过程的指标-正念-与功能的相关性相对较弱，特别是与内容指标(灾难性和自我效能感)更强、更一致的发现相比。此外，这些结果为正念可能既有好处也有代价的可能性提供了初步证据。评估这种可能性的研究是有必要的。
Pain-related cognitive content (what people think about pain) and cognitive processes (how people think about pain; what they do with their pain-related thoughts) and their interaction are hypothesized to play distinct roles in patient function. However, questions have been raised regarding whether it is possible or practical to assess cognitive content and cognitive process as distinct domains. The aim of this study was to determine the extent to which measures that appear to assess mostly pain-related cognitive content, cognitive processes, and content and process, are relatively independent from each other and contribute unique variance to the prediction of patient function. Individuals with chronic low back pain (N=165) participating in an ongoing RCT were administered measures of cognitions, pain, and function (depressive symptoms and pain interference) pre-treatment. Analyses provided support for the hypothesis that cognitive content and cognitive process, while related, can be assessed as distinct components. However, the measure assessing a cognitive process – mindfulness – evidenced relatively weak associations with function, especially compared with the stronger and more consistent findings for the measures of content (catastrophizing and self-efficacy). Moreover, the results provide preliminary evidence for the possibility that mindfulness could have both benefits and costs. Research to evaluate this possibility is warranted.