Pain-related catastrophizing and perceived social responses: Inter-relationships in the context of chronic pain
Pain-related catastrophizing and perceived social responses: Inter-relationships in the context of chronic pain
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DOI：
10.1016/j.pain.2006.08.018
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发表时间：
2007-02-01
期刊：
影响因子：
7.4
通讯作者：
Haythornthwaite, Jennifer A.
中科院分区：
文献类型：
--
作者：
Buenaver, Luis F.;Edwards, Robert R.;Haythornthwaite, Jennifer A.
与疼痛相关的应对，特别是灾难化，在形成疼痛反应中起着重要作用。假设灾难化放大疼痛和残疾的一种方式是通过其对患者社会环境的影响（例如，社区应对模式），但经验支持有限。本研究在1356名疼痛患者的样本中测试了灾难性和有害的疼痛相关结果之间的关联是否由患者对重要他人对其疼痛的反应的感知介导。回归分析表明，感知到的其他惩罚性反应部分介导了灾难化与疼痛相关残疾的关系，并与抑郁症状。此外，有几个变量缓和的灾难和感知的社会反应疼痛之间的关联。对于疼痛持续时间相对较短的患者，灾难化与更大的感知关怀反应更密切相关。此外，更高的灾难化更强烈地与感知惩罚反应患者感知社会支持较低。此外，知觉惩罚反应的中介效应灾难化的关系与抑郁症状，与疼痛相关的残疾，只发现在个人报告低水平的社会支持。总之，感知社会反应被发现在调解灾难化和疼痛相关结果之间的关系中发挥了很小的作用，这些中介作用可能在特定的患者亚组中最强。目前的数据表明，人际机制可能不会构成一个主要的途径，灾难化发挥其适应不良的影响疼痛反应。研究和进一步了解哪些主要因素介导了灾难化对疼痛的有害影响，对于阐明疼痛的生物心理社会模型将是重要的。由Elsevier B.V.代表国际疼痛研究协会出版。
Pain-related coping, particularly catastrophizing, plays a significant role in shaping pain responses. One way catastrophizing is hypothesized to amplify pain and disability is via its effect on patients' social environments (e.g., communal coping model), though empirical support is limited. The present study tested whether the association between catastrophizing and deleterious pain-related outcomes was mediated by patients' perceptions of significant others' responses to their pain in a sample of 1356 pain patients. Regression analyses showed that perceived significant other punishing responses partially mediated catastrophizing's relationship with pain-related disability, and with depressive symptoms. Further, several variables moderated the association between catastrophizing and perceived social responses to pain. Catastrophizing was more strongly associated with greater perceived solicitous responses for patients of relatively short pain duration. Also, higher catastrophizing was more strongly associated with perceived punishing responses among patients perceiving lower social support. In addition, the mediational effects of perceived punishing responses on catastrophizing's relationship with depressive symptoms, and with pain-related disability were only found in individuals reporting low levels of perceived social support. In sum, perceived social responses were found to play a small role in mediating the relationship between catastrophizing and pain-related outcomes, and these mediational effects may be strongest in particular patient subgroups. The present data suggest that interpersonal mechanisms may not constitute a primary route by which catastrophizing exerts its maladaptive effects on pain responses. The study and further understanding of what principal factors mediate catastrophizing's deleterious effects on pain will be important in illuminating the biopsychosocial model of pain. Published by Elsevier B.V. on behalf of International Association for the Study of Pain.