Affective instability in patients with chronic pain: a diary approach
Affective instability in patients with chronic pain: a diary approach
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DOI：
10.1097/j.pain.0000000000000582
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发表时间：
2016-08-01
期刊：
影响因子：
7.4
通讯作者：
Crombez, Geert
中科院分区：
文献类型：
--
作者：
Rost, Silke;Van Ryckeghem, Dimitri M. L.;Crombez, Geert
情感不稳定，概念上是情绪随时间的波动，与健康状况不佳和精神病理学有关。在这项研究中，我们研究了70例慢性疼痛患者（M-年龄= 49.7岁; 46名女性）的情绪不稳定性对日常疼痛结果的作用，使用一天结束的日记。在基线阶段，患者完成自我报告的问卷调查，包括疼痛严重程度、疼痛持续时间、残疾、抑郁和焦虑。在随后的日记阶段，患者连续14天填写电子日终日记，评估疼痛严重程度、残疾、认知主诉、负面影响（NA）和正面影响的每日水平。情感不稳定性被操作为日常情绪的连续差异的均方（分别为NA和积极的影响），它考虑到了连续几天的情感变化的大小。结果表明，NA不稳定与日常残疾呈正相关，超出了日常疼痛严重程度的影响。此外，NA不稳定性调节日常疼痛严重程度和日常残疾之间的关系，以及日常疼痛严重程度和日常认知投诉之间的关系。然而，积极影响不稳定性与所有结果无关。目前的研究结果扩展了以前的研究结果，揭示了情感不稳定对疼痛相关结果的假定作用，并可能产生重要的临床意义。事实上，他们建议通过改善情绪调节技能来靶向NA不稳定性可能是减少慢性疼痛患者残疾和认知投诉的策略。
Affective instability, conceptualized as fluctuations in mood over time, has been related to ill-health and psychopathology. In this study, we examined the role of affective instability on daily pain outcomes in 70 patients with chronic pain (M-age = 49.7 years; 46 females) using an end-of-day diary. During a baseline phase, patients completed self-reported questionnaires of pain severity, pain duration, disability, depression, and anxiety. During a subsequent diary phase, patients filled out an electronic end-of-day diary over 14 consecutive days assessing daily levels of pain severity, disability, cognitive complaints, negative affect (NA) and positive affect. Affective instability was operationalized as the mean square of successive differences in daily mood (separately for NA and positive affect), which takes into account the size of affective changes over consecutive days. Results indicated that NA instability was positively associated with daily disability, beyond the effects of daily pain severity. Furthermore, NA instability moderated the relationship between daily pain severity and daily disability and the relationship between daily pain severity and daily cognitive complaints. Positive affect instability, however, showed to be unrelated to all outcomes. Current findings extend previous results and reveal the putative role of affective instability on pain-related outcomes and may yield important clinical implications. Indeed, they suggest that targeting NA instability by improving emotion regulation skills may be a strategy to diminish disability and cognitive complaints in patients with chronic pain.