Evidence for indirect effects of pain catastrophizing on clinical pain among myofascial temporomandibular disorder participants: The mediating role of sleep disturbance
Evidence for indirect effects of pain catastrophizing on clinical pain among myofascial temporomandibular disorder participants: The mediating role of sleep disturbance
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DOI：
10.1016/j.pain.2012.01.023
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发表时间：
2012-06-01
期刊：
影响因子：
7.4
通讯作者：
Smith, Michael T.
中科院分区：
文献类型：
--
作者：
Buenaver, Luis F.;Quartana, Phillip J.;Smith, Michael T.
睡眠障碍和疼痛灾难化是慢性疼痛体验的重要介质。迄今为止，这些因素尚未同时考虑，尽管令人信服的理论理由这样做。在本研究中，我们研究了疼痛灾难化是否不仅对临床疼痛和疼痛相关干扰有直接影响，而且还通过其与睡眠障碍的关联产生间接影响。我们使用一组（n = 214）肌筋膜颞下颌关节紊乱病的参与者，使用统计引导技术建议测试的间接影响，评估这一假设。结果表明，疼痛灾难化与更大的睡眠障碍，并在临床疼痛的严重程度和疼痛相关的干扰归因于疼痛灾难化的显着部分的方差介导的睡眠障碍。补充分析显示，灾难化的反刍成分似乎通过睡眠障碍与临床结果间接相关。没有证据表明间接影响观察无助和放大组件。这些结果表明，对疼痛的沉思可能会通过睡眠的改变间接导致临床疼痛。需要前瞻性研究来检查这些结构之间的滞后关联。这些发现具有重要的理论和临床意义。重要的是，减少疼痛灾难化的干预措施可以同时改善睡眠和临床疼痛。(C)2012年国际疼痛研究协会。由Elsevier B出版。V.保留所有权利。
Sleep disturbance and pain catastrophizing are important mediators of the chronic pain experience. To date, these factors have not been considered concurrently despite compelling theoretical rationale to do so. In the present study, we examined whether pain catastrophizing not only has direct effects on clinical pain and pain-related interference, but also indirect effects through its association with sleep disturbance. We evaluated this hypothesis using a cohort (n = 214) of myofascial temporomandibular disorder participants using a statistical bootstrapping technique recommended for tests of indirect effects. Results suggested that pain catastrophizing was associated with greater sleep disturbance, and that a significant portion of variance in clinical pain severity and pain-related interference attributable to pain catastrophizing was mediated by sleep disturbance. Supplementary analyses revealed that the rumination component of catastrophizing seemed to be indirectly related to clinical outcomes through sleep disturbance. No evidence for indirect effects was observed for helplessness and magnification components. These results suggest that rumination about pain may contribute to clinical pain indirectly through alterations in sleep. Prospective studies are needed to examine lagged associations between these constructs. These findings have important theoretical and clinical implications. Critically, interventions that reduce pain catastrophizing may concurrently improve sleep and clinical pain. (C) 2012 International Association for the Study of Pain. Published by Elsevier B. V. All rights reserved.