The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain.

The Role of Psychosocial Processes in the Development and Maintenance of Chronic Pain.
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心理社会过程在慢性疼痛发展和维持中的作用。

DOI:
10.1016/j.jpain.2016.01.001
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发表时间:
2016-09
期刊:
影响因子:
4
通讯作者:
Wasan, Ajay D.
Wasan, Ajay D.
中科院分区:
医学2区
文献类型:
--
作者:
Edwards, Robert R.;Dworkin, Robert H.;Sullivan, Mark D.;Turk, Dennis C.;Wasan, Ajay D.

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最近提出的ACTTION-APS疼痛分类法提供了一个基于证据的多维慢性疼痛分类系统。心理社会因素在分类学的几个方面发挥着至关重要的作用。在本文中,我们讨论了影响慢性疼痛障碍的诊断和轨迹的社会心理因素的评估。我们回顾了对患有各种持续性疼痛状况的个体的研究,并描述了心理社会变量在赋予疼痛发展风险、形成长期疼痛相关调整和调节疼痛治疗结果方面发挥关键作用的证据。我们既考虑了“一般”心理社会变量,如负面影响,童年创伤和社会支持,以及“疼痛特异性”心理社会变量,包括疼痛相关的灾难化,自我效能管理疼痛,疼痛相关的应对。总的来说,慢性疼痛的复杂性和深刻的变异性突出了更好地理解决定慢性疼痛状况轨迹的多维相互作用力量的必要性。
The recently-proposed ACTTION-APS Pain Taxonomy provides an evidence-based, multidimensional, chronic pain classification system. Psychosocial factors play a crucial role within several dimensions of the Taxonomy. In this paper, we discuss the evaluation of psychosocial factors that influence the diagnosis and trajectory of chronic pain disorders. We review studies in individuals with a variety of persistent pain conditions, and describe evidence that psychosocial variables play key roles in conferring risk for the development of pain, in shaping long-term pain-related adjustment, and in modulating pain treatment outcomes. We consider both “general” psychosocial variables such as negative affect, childhood trauma, and social support, as well as “pain-specific” psychosocial variables that include pain-related catastrophizing, self-efficacy for managing pain, and pain-related coping. Collectively, the complexity and profound variability in chronic pain highlights the need to better understand the multidimensional array of interacting forces that determine the trajectory of chronic pain conditions.
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