Beyond pain catastrophizing: rationale and recommendations for targeting trauma in the assessment and treatment of chronic pain.
Beyond pain catastrophizing: rationale and recommendations for targeting trauma in the assessment and treatment of chronic pain.
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除了疼痛灾难化：在慢性疼痛评估和治疗中针对创伤的基本原理和建议。
DOI：
10.1080/14737175.2024.2311275
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发表时间：
2024
影响因子：
4.3
通讯作者：
Edwards,RobertR
中科院分区：
文献类型：
--
作者：
Yamin,JolinB;Meints,SamanthaM;Edwards,RobertR
1.背景认知因素，例如适应不良的疼痛信念，对于慢性疼痛的发展和治疗至关重要。慢性疼痛强度和疼痛相关残疾最重要的认知相关性之一是疼痛灾难化 (PC)，通常定义为放大疼痛威胁和解释的倾向 [引用 1-3]。痛苦灾难化由三个方面组成：沉思，重复关注痛苦的症状；放大、对疼痛威胁的夸大感知和预期；以及无助感，即感觉到无法施加控制[引文 1]。减少 PC 是一种关键机制，广泛采用的慢性疼痛心理治疗黄金标准，例如认知行为疗法 (CBT) 和接受与承诺疗法 (ACT)，据称可以改善疼痛相关的结果 [引文 4-7]。尽管这些经验支持的治疗方法有大量的证据基础，但它们对慢性疼痛的总体影响不大。例如，对慢性疼痛心理疗法的全面综述发现，CBT 和 ACT 在减轻慢性疼痛患者的疼痛、残疾和痛苦方面具有微小的有益作用 [引文 8]。造成这些适度影响的一个潜在因素可能是，患者病史中与 PC 和疼痛相互作用并加剧 PC 和疼痛的重要因素往往被排除在金标准慢性疼痛治疗之外。这些因素包括心理创伤史和不良童年经历（ACE），这些因素在慢性疼痛患者中很常见，但没有得到常规评估和治疗。在本文中，我们认为有效的慢性疼痛治疗，特别是那些针对减少 PC 的治疗，还应该包括对创伤的彻底评估和治疗，认识到它是 PC 和慢性疼痛的重要和潜在的潜在因素。我们还提供将创伤知情护理纳入医疗和心理健康实践的建议，以实现更有效和个性化的慢性疼痛管理。
1. BackgroundCognitive factors, such as maladaptive pain beliefs, are central to the development and management of chronic pain. One of the most important cognitive correlates of chronic pain intensity and pain-related disability is pain catastrophizing (PC), generally defined as the tendency to magnify the threat and interpretation of pain [Citation 1–3]. Pain catastrophizing is comprised of three dimensions: rumination, the repetitive focus on symptoms of distress; magnification, an exaggerated perception and anticipation of the threat of pain; and helplessness, a perceived inability to exert control [Citation 1]. Reduction in PC is a key mechanism through which gold standard, widely-adopted psychological treatments for chronic pain, such as Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), are purported to improve pain-related outcomes [Citation 4–7]. Although these empirically-supported treatments have a large evidence base, their overall effects on chronic pain are modest. For example, a comprehensive review of psychological therapies for chronic pain found that CBT and ACT have small beneficial effects in reducing pain, disability, and distress in patients with chronic pain [Citation 8]. One potential contributor to these modest effects may be that important factors from patients’ histories that interact with and exacerbate PC and pain are often left out of gold standard chronic pain treatments. Such factors include histories of psychological trauma and adverse childhood experiences (ACEs), which are common yet not routinely assessed and treated among patients with chronic pain. In this paper, we argue that effective chronic pain treatments, specifically those targeting the reduction in PC, should also incorporate a thorough assessment and treatment of trauma, recognizing it as a significant and potential underlying factor in PC and chronic pain. We also provide recommendations for integrating trauma-informed care into both medical and mental health practices for more effective and personalized chronic pain management.
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影响因子：
4
作者：
Edwards, Robert R.;Dworkin, Robert H.;Sullivan, Mark D.;Turk, Dennis C.;Wasan, Ajay D.
通讯作者：
Wasan, Ajay D.
概念化和治疗合并症的慢性疼痛和PTSD。
影响因子：
--
作者：
Bosco MA;Gallinati JL;Clark ME
通讯作者：
Clark ME
慢性疼痛和创伤后应激障碍：永久回避模型及其治疗意义。
DOI：
--
发表时间：
2008
期刊：
Torture : quarterly journal on rehabilitation of torture victims and prevention of torture
影响因子：
--
作者：
A. Liedl;C. Knaevelsrud
通讯作者：
C. Knaevelsrud
当情感上的痛苦变成身体上的：不良童年经历、疼痛以及情绪和焦虑症的作用。
影响因子：
3
作者：
Sachs-Ericsson,NatalieJ;Sheffler,JuliaL;Stanley,IanH;Piazza,JenniferR;Preacher,KristopherJ
通讯作者：
Preacher,KristopherJ