Understanding Pain and Depression in Back Pain: the Role of Catastrophizing, Help-/Hopelessness, and Thought Suppression as Potential Mediators
Understanding Pain and Depression in Back Pain: the Role of Catastrophizing, Help-/Hopelessness, and Thought Suppression as Potential Mediators
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DOI：
10.1007/s12529-015-9522-y
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发表时间：
2016-06-01
影响因子：
2.7
通讯作者：
Rusu, Adina C.
中科院分区：
文献类型：
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作者：
Huelsebusch, Janina;Hasenbring, Monika I.;Rusu, Adina C.
目的 认知中介假说描述了心理因素对疼痛和抑郁之间关系的影响，例如灾难化和帮助/绝望的认知。最近的研究还强调了抑制负面想法和经历（例如疼痛）的作用。然而，很少有研究调查这些对比认知的直接和间接影响。方法共有164名急性和亚急性非特异性背痛患者参与了本研究。使用问卷测量疼痛强度、抑郁和与疼痛相关的认知，例如贝克抑郁量表和基尔疼痛量表。使用结构方程模型分析数据。结果路径分析的结果支持认知应对策略对疼痛和抑郁具有中介作用的假设。与之前的研究一致，我们发现疼痛与抑郁没有直接关系。帮助/绝望是导致抑郁的直接途径，而灾难化则通过增加帮助/绝望而产生间接影响。目前的结果还表明，思想抑制通过直接和间接作用介导疼痛和抑郁之间的关系。 结论 认知调节因素，如帮助/绝望、灾难化和思想抑制，对急性和亚急性背痛患者的抑郁有显着影响。目前的结果可能有助于通过将注意力集中在功能失调的认知疼痛应对策略的修改上来优化这些患者的治疗。
Purpose The cognitive mediation hypothesis describes the influence of psychological factors on the relationship between pain and depression such as cognitions of catastrophizing and help-/hopelessness. More recent research also emphasizes the role of suppression of negative thoughts and experiences such as pain. However, there is little research investigating direct and indirect effects of these contrasting cognitions.Method A total of 164 acute and sub-acute non-specific back pain patients participated in this study. Pain intensity, depression, and pain-related cognitions were measured using questionnaires, such as the Beck Depression Inventory and the Kiel Pain Inventory. Data were analyzed using structural equation modeling.Results The results of the path analysis support the hypothesis that cognitive coping strategies have a mediating effect on pain and depression. Consistent with previous research, we found that pain had no direct relation with depression. Help-/hopelessness had a direct path to depression, whereas catastrophizing had an indirect effect via increased help-/hopelessness. The current results also indicate that thought suppression mediated the relationship between pain and depression via both direct and indirect effects.Conclusion Cognitive mediators, such as help-/hopelessness, catastrophizing, and thought suppression, have a significant impact on depression in patients with acute and sub-acute back pain. The current results may aid in the optimization of treatments for these patients by focusing attention toward the modification of dysfunctional cognitive paincoping strategies.