Self System Therapy and Chronic Low Back Pain

描述（由申请人提供）：慢性腰痛（CLBP）患者科普与其疾病相关的许多主要生活挑战，包括工作能力的变化以及身体和情绪健康的下降。这些变化改变了CLBP患者追求和实现重要个人目标并达到个人标准的能力。因此，CLBP患者极有可能在自我调节方面遇到重大困难，即，为了达到重要的个人目标和标准而评估和调节自己行为的持续过程。反过来，无法达到重要的目标和标准会增加患抑郁症的风险。这项研究的长期目标是减少CLBP患者患抑郁症所经历的抑郁、疼痛、心理残疾和身体残疾。这项拟议中的研究旨在评估自我系统疗法（SST）的疗效，SST是一种专门针对自我调节问题的抑郁症新疗法。总共174名符合DSM-IV重度抑郁症标准的CLBP患者将被随机分配到三种情况之一：1）自我系统治疗（SST）-适合CLBP患者关注的SST的12个疗程版本; 2）背痛教育-为患者提供慢性腰痛的性质和治疗信息的比较条件;或3）标准护理条件-患者将接受他们所要求的护理并由他们的健康护理提供者提供给他们的控制条件。在治疗前后以及6个月和12个月随访时收集的评估指标将包括抑郁、身体和心理残疾、疼痛和应对自我效能、自我调节重点和自我差异。还将收集疼痛、情绪、目标激活/实现和压力的日常测量。转换的原因和不成功的自我调节的抑郁症的诊断和治疗CLBP患者的后果的基本知识，代表了一个有前途的途径，确定适合这些人的治疗方案。

DESCRIPTION (provided by applicant): Patients with chronic low back pain (CLBP) cope with numerous major life challenges associated with their disorder, including changes in their ability to work, as well as decrements in physical and emotional well being. These changes alter CLBP patients' ability to pursue and achieve important personal goals and live up to personal standards. As a result, CLBP patients are highly likely to experience substantial difficulties with self-regulation, i.e., the ongoing process of evaluating and regulating one's behaviors so as to meet important personal goals and standards. In turn, the inability to attain important goals and standards increases risk for depression. The long-range goal of this research is to reduce the depression, pain, psychological disability, and physical disability experienced by CLBP patients suffering from depression. The proposed study seeks to evaluate the efficacy of Self-System Therapy (SST), a new therapy for depression specifically targeting problems in self-regulation. A total of 174 CLBP patients who meet DSM-IV criteria for major depressive disorder will be randomly assigned to one of three conditions: 1) Self-System Therapy (SST) - a twelve-session version of SST adapted to the concerns of CLBP patients; 2) Back Pain Education - a comparison condition that provides patients with information on the nature and treatment of chronic low back pain; or, 3) Standard Care Condition - a control condition in which patients will receive care requested by them and made available to them by their health care provider. Assessment measures to be gathered before and after treatment and at 6- and 12-month follow-up will include depression, physical and psychosocial disability, pain and coping self-efficacy, self-regulatory focus, and self-discrepancies. Daily measures of pain, mood, goal activation/attainment, and stress will also be gathered. Converting basic knowledge about the causes and consequences of unsuccessful self-regulation to the diagnosis and treatment of depression in CLBP patients represents a promising avenue for identifying treatment options appropriate for these individuals.