Coping with chronic pain: Flexible goal adjustment as an interactive buffer against pain-related distress
Coping with chronic pain: Flexible goal adjustment as an interactive buffer against pain-related distress
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DOI：
10.1016/0304-3959(96)03108-9
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发表时间：
1996-09-01
期刊：
影响因子：
7.4
通讯作者：
Nilges, P
中科院分区：
文献类型：
--
作者：
Schmitz, U;Saile, H;Nilges, P
在本研究中，Brandtstadter（1992）区分了同化和适应作为应对的两种基本手段，并将其应用于慢性疼痛领域。同化应对包括积极尝试（如工具性活动、自我纠正行动、补偿措施），根据个人偏好改变不满意的生活环境和情境限制。相反，适应性应对（例如降低期望、积极的重新评价、自我增强的比较）是针对根据感知到的缺陷和损失修订自我评价和个人目标标准。我们的研究是基于慢性疼痛可以被描述为威胁或阻碍个人目标的主要来源的假设。当目标不再被认为可以通过积极的同化应对努力实现时，适应性应对在处理慢性疼痛方面应该变得越来越重要。对120例慢性疼痛患者的同化性（顽强的目标追求）和适应性应对倾向（灵活的目标调整）以及疼痛相关应对和调整指标（抑郁、疼痛相关残疾、疼痛强度）的性格差异进行了评估。结果表明，适应性应对作为一种保护性资源，可以防止慢性疼痛患者心理功能的整体丧失，并保持积极的人生观。最重要的是，灵活调整个人目标的能力减弱了疼痛经历（疼痛强度、疼痛相关残疾）对心理健康（抑郁）的负面影响。此外，与疼痛相关的应对策略只有在高度灵活的目标调整的情况下才能减少残疾。这些发现对应对研究和慢性疼痛患者治疗的理论和临床意义进行了讨论。
In the present study, Brandtstadter's (1992) distinction between assimilation and accommodation as two fundamental means of coping is applied to the field of chronic pain. Assimilative coping involves active attempts (e.g. instrumental activities, self-corrective actions, compensatory measures) to alter unsatisfactory life circumstances and situational constraints in accordance with personal preferences. Conversely, accommodative coping (e.g. downgrading of aspirations, positive reappraisal, self-enhancing comparisons) is directed towards a revision of self-evaluative and personal goal standards in accordance with perceived deficits and losses. Our research is based on the assumption that chronic pain can be described as a major source of threat or impediment to personal goals. When goals are no longer perceived to be attainable through active-assimilative coping efforts, accommodative coping should become increasingly important in dealing with chronic pain. In a study of 120 chronic pain patients, dispositional differences in assimilative (tenacious goal pursuit) and accommodative coping tendencies (flexible goal adjustment), as well as measures of pain-related coping and adjustment (depression, pain-related disability, pain intensity) were assessed. The results suggest that accommodative coping functions as a protective resource by preventing global losses in the psychological functioning of chronic pain patients and maintaining a positive life perspective. Most important, the ability to flexibly adjust personal goals attenuated the negative impact of the pain experience (pain intensity, pain-related disability) on psychological well-being (depression). Furthermore, pain-related coping strategies led to a reduction of disability only when accompanied by a high degree of flexible goal adjustment. The theoretical and clinical implications of these findings for coping research and the treatment of chronic pain patients are discussed.