Abstract

Objective 

To propose a new model outlining a hypothesized cyclical relation between executive functioning, emotional regulation, and chronic pain in adolescence and to highlight the likely importance of such a relation for self-management behavior and pain-related disability.

Methods 

A review of the existing literature that critically explores the role of executive functioning in understanding chronic pain experiences and self-management in adolescence in order to develop the Cyclical model Of Pain, Executive function, emotion regulation, and Self-management (COPES).

Results 

Growing evidence points towards a potential cyclical relation between chronic pain and impaired executive functioning, which forms the basis of COPES. The COPES model proposes that the relative immaturity of executive functioning in adolescence negatively influences their ability to engage with self-management, which in turn increases adolescents’ disability due to pain and contributes to the maintenance of chronic pain, which perpetuates the reduced capacity of executive functioning. The moderating influence of flexible parental support is hypothesized to offset some of these influences. However, the available evidence is limited due to methodological shortcomings such as large variety in executive functioning operationalization, reliance on self-report and cross-sectional designs.

Conclusions 

It is anticipated that the COPES model will stimulate more systematic, theory-driven research to further our understanding of the links between executive functioning, chronic pain, self-management, and wellbeing. Such enhanced understanding has the potential to drive forward intervention development and refinement aimed at improving self-management uptake and adherence amongst adolescents with chronic pain.

中文翻译：

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慢性疼痛，执行功能，情绪调节和自我管理之间的周期性关系

摘要

客观的 

提出一种新的模型，概述执行功能，情绪调节和青春期慢性疼痛之间的假设周期性关系，并强调这种关系对自我管理行为和与疼痛相关的残疾的重要性。

方法 

对现有文献的回顾，该文献批判性地探讨了执行功能在理解青春期慢性疼痛经历和自我管理中的作用，以开发疼痛，执行功能，情绪调节和自我管理（COPES）的周期性模型。

结果 

越来越多的证据表明，慢性疼痛与执行功能受损之间存在潜在的周期性关系，这构成了COPES的基础。COPES模型提出，青春期执行机构功能的相对不成熟会对他们进行自我管理产生负面影响，这反过来会增加青少年因疼痛而造成的残疾，并有助于维持慢性疼痛，从而使执行机构的能力不断下降。运作。据推测，灵活的父母支持的适度影响可以抵消其中一些影响。但是，由于方法上的缺陷，例如执行职能运作的多样性大，对自我报告和横截面设计的依赖等，现有证据有限。

结论 

预计COPES模型将激发更多系统的，理论驱动的研究，以进一步理解执行功能，慢性疼痛，自我管理和幸福之间的联系。这种增进的理解有可能推动干预措施的发展和完善，以期改善患有慢性疼痛的青少年的自我管理能力和依从性。