The role of pain-related anxiety in adolescents' disability and social impairment: ALSPAC data
The role of pain-related anxiety in adolescents' disability and social impairment: ALSPAC data
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DOI：
10.1002/ejp.611
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发表时间：
2015-07-01
影响因子：
3.6
通讯作者：
Eccleston, C.
中科院分区：
文献类型：
--
作者：
Caes, L.;Fisher, E.;Eccleston, C.
背景焦虑，特别是与疼痛相关的焦虑，在解释患有慢性疼痛的成人和儿童的疼痛主诉和疼痛相关残疾的严重程度方面发挥着重要作用。恐惧回避模型（FAM）描述了与疼痛相关的焦虑如何在维持疼痛回避行为中发挥关键作用，进而影响与疼痛相关的残疾。然而，FAM 没有考虑到青春期更广泛的方面，例如社会功能，这可能会受到焦虑的负面影响。此外，大多数研究焦虑在疼痛中的作用的研究都使用了少量的便利样本或临床样本。通过使用英国大型流行病学数据库，本研究调查了与疼痛相关的焦虑、残疾和社交障碍判断之间的关联。方法从一项更大规模的流行病学研究（雅芳父母和儿童纵向研究）中选择患有复发性疼痛的参与者（n = 856），研究对象为 17 岁参加研究诊所的青少年（n = 5170）。青少年完成了一份关于疼痛相关焦虑、残疾和感知社交障碍的自我报告问卷。结果高水平的疼痛相关焦虑与更多残疾相关。在女孩中，与同龄人相比，较高水平的与疼痛相关的焦虑也与自我感觉社会功能受损程度更大有关。结论与疼痛相关的焦虑与更大的与疼痛相关的残疾和社会功能受损有关。应将社会功能作为青少年慢性疼痛的恐惧回避模型的一个组成部分进行探索。
BackgroundAnxiety, in particular pain-related anxiety, plays an important role in explaining the severity of pain complaints and pain-related disability in both adults and children with chronic pain. The fear-avoidance model (FAM) describes how pain-related anxiety plays a critical role in the maintenance of pain-avoidance behaviour, which in turn influences pain-related disability. However, the FAM does not take into account broader aspects of adolescence, such as social functioning, which could be negatively impacted by anxiety. In addition, most studies examining the role of anxiety in pain have used small convenience or clinical samples. By using a large UK epidemiological database, this study investigated the associations between pain-related anxiety, disability and judgements of social impairment.MethodsParticipants (n=856) with recurrent pain were selected from a larger epidemiological study (Avon Longitudinal Study of Parents and Children) of adolescents attending a research clinic at the age of 17 (n=5170). Adolescents completed a self-report questionnaire on pain-related anxiety, disability and perceived social impairment.ResultsHigh levels of pain-related anxiety were associated with more disability. In girls, higher levels of pain-related anxiety were also related to the self-perception of greater impairment in social functioning compared with their peers.ConclusionsPain-related anxiety was associated with greater pain-related disability and impaired social functioning. Social functioning should be explored as an integral part of fear-avoidance models of adolescent chronic pain.