ABSTRACT

Recent evidence suggests that individuals living with chronic pain demonstrate reduced tolerance of uncertainty compared to healthy individuals. Intolerance of uncertainty often lead to excessive worry, which may be related not only to the tendency to catastrophize pain, but also to increased distress. However, the specific nature of these relationships remains largely unexplored. The present study sought to investigate the associations between intolerance of uncertainty, pain catastrophizing, and symptoms of depression, while exploring how they differ between adults with and without chronic pain. Questionnaires were administered electronically to a community sample of 160 adults. All variables were significantly and positively correlated in the chronic pain group (n = 80), while only intolerance of uncertainty and symptoms of depression were positively and strongly correlated in the pain-free group (n = 80). Individuals in the chronic pain group reported higher levels of pain catastrophizing and symptoms of depression compared to the pain-free group, but both groups exhibited similar levels of intolerance of uncertainty. Intolerance of uncertainty and pain catastrophizing were significant predictors of the severity of depression in both groups, even after controlling for age and gender. However, intolerance of uncertainty was no longer statistically significant in the chronic pain group once pain catastrophizing was considered. These findings suggest that intolerance of uncertainty serves as a general vulnerability factor for psychological distress in adults, while pain catastrophizing acts as a specific vulnerability factor for individuals living with chronic pain. Enhancing knowledge about the role of cognitive factors in depression among individuals with chronic pain could help improve the management of this debilitating condition.

摘要

最近的证据表明，与健康人相比，患有慢性疼痛的人对不确定性的容忍度较低。对不确定性的不容忍往往会导致过度担忧，这可能不仅与灾难化痛苦的倾向有关，而且还与增加痛苦有关。然而，这些关系的具体性质在很大程度上仍未得到探索。本研究旨在调查无法容忍不确定性、疼痛灾难化和抑郁症状之间的关联，同时探讨患有和不患有慢性疼痛的成年人之间的差异。对 160 名成年人的社区样本进行了电子问卷调查。在慢性疼痛组（ n = 80）中，所有变量均呈显着正相关 ，而在无痛组（n  = 80）中，只有对不确定性的不耐受性和抑郁症状呈显着正相关。与无痛组相比，慢性疼痛组的个体报告了更高水平的疼痛灾难性和抑郁症状，但两组都表现出相似程度的不容忍不确定性。即使在控制了年龄和性别之后，对不确定性的不容忍和痛苦的灾难化也是两组抑郁症严重程度的重要预测因素。然而，一旦考虑到疼痛灾难化，慢性疼痛组对不确定性的不耐受就不再具有统计学意义。这些发现表明，对不确定性的不容忍是成年人心理困扰的一个普遍脆弱因素，而灾难性疼痛则是慢性疼痛患者的一个特定脆弱因素。增强对慢性疼痛患者抑郁症中认知因素作用的了解，有助于改善这种令人衰弱的疾病的治疗。