The role of affect in chronic pain: A systematic review of within-person symptom dynamics.
The role of affect in chronic pain: A systematic review of within-person symptom dynamics.
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DOI：
10.1016/j.jpsychores.2021.110527
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发表时间：
2021-08
影响因子：
4.7
通讯作者：
Rodebaugh, Thomas L.
中科院分区：
文献类型：
--
作者：
Frumkin, Madelyn R.;Rodebaugh, Thomas L.
慢性疼痛被概念化为一种涉及生理和情感过程的生物、心理和社会现象。关于慢性疼痛的这些方面的绝大多数研究都描述了个体之间的差异。在这篇综述中，我们描述了假设人与人之间的差异准确地表征人内过程的问题。我们还系统地回顾了一些研究，这些研究考察了慢性疼痛患者的疼痛和情感之间的人际关系。到2020年12月发表的与疼痛和情感、情感或情绪的面对面评估有关的文章被确定。提取和总结了关于研究设计、依从性以及疼痛和情感变量之间的当前和预期关系的数据。在611篇摘要中，55篇研究符合纳入标准。结果表明，慢性疼痛的个体在经历更严重的疼痛时，往往会经历更多的负面情绪和更少的积极情绪(Rpooled=.18和−.19)。然而，这些影响的大小似乎小于人与人之间的联系，而且有证据表明个体之间存在显著的差异。对疼痛和情感之间的预测关系的研究很大程度上表明，症状倾向于预测自己，而不是疼痛预测情感，反之亦然。与群体层面的关系一致，相对于个人平均水平，经历更严重的疼痛似乎与更多的负面情绪和更少的积极情绪有关。然而，每个人在这些影响的大小甚至方向上都有所不同。有必要进行更多的研究，以了解这种变异性对慢性疼痛的评估和治疗的影响。
Chronic pain is conceptualized as a biopsychosocial phenomenon that involves both physical and emotional processes. The vast majority of research regarding these facets of chronic pain characterizes differences between individuals. In this review, we describe problems with assuming that differences between persons accurately characterize within-person processes. We also provide a systematic review of studies that have examined within-person relationships between pain and affect among individuals with chronic pain. Articles published by December 2020 that pertained to within-person assessment of pain and emotion, affect, or mood were identified. Data regarding study design, adherence, and concurrent and prospective relationships among pain and affect variables were extracted and summarized. Of 611 abstracts, 55 studies met inclusion criteria. Results suggest that individuals with chronic pain tend to experience increased negative affect and decreased positive affect when experiencing more severe pain (rpooled = .18 and −.19, respectively). However, the size of these effects appeared smaller than between-person associations, and there was evidence of significant variability between individuals. Examination of predictive relationships between pain and affect largely suggested the tendency of symptoms to predict themselves, rather than pain predicting affect or vice versa. Consistent with group-level relationships, experiencing more severe pain relative to an individual’s average seems to be associated with more negative affect and less positive affect. However, individuals vary in the size and even direction of these effects. More research is necessary to understand the implications of such variability for the assessment and treatment of chronic pain.
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