Abstract

Objective 

Several factors are known to impact response to the intensive interdisciplinary pain treatment (IIPT) program described in this study, yet no research has explored the role of perfectionism. This secondary data analysis explored direct and indirect relations between perfectionism and functional disability (primary outcome) and pain severity (secondary outcome) after IIPT, with pain catastrophizing and fear of pain as mediators.

Methods 

Youth (N = 253) aged 8–21 with chronic pain and associated disability completed pre- and post-IIPT measures of self-oriented perfectionism (SOP), socially prescribed perfectionism (SPP), pain catastrophizing, fear of pain, functional disability, and pain characteristics for routine clinical care and this nonrandomized trial. Eight mediated models were run for the two predictors, two mediators, and two outcomes.

Results 

Pretreatment perfectionism (SOP and SPP) led to greater reductions in pain catastrophizing over the course of IIPT, which resulted in lower pain severity (β = −.02 [CI = −0.07, −0.01] for SOP and β = −.02 [CI = −0.06, −0.003] for SPP) and less functional disability (β = −.06 [CI = −0.13, −0.01] for SOP and β = −.06 [CI = −0.14, −0.01] for SPP). Independent of pain catastrophizing, pretreatment SPP was directly associated with more posttreatment functional disability (β = .16 [CI = 0.05, 0.27]). Fear of pain was not a mediator.

Conclusions 

Findings suggest perfectionism has the potential to negatively impact IIPT outcomes. However, when perfectionistic youth with chronic pain learn to manage pain-related distress, they benefit. Results highlight the importance of assessing for and treating perfectionism and pain-related distress in youth with chronic pain.

中文翻译：

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了解完美主义如何影响强化的跨学科疼痛治疗结果：一项非随机试验

摘要

客观的 

已知有几个因素会影响对本研究中所述的强化跨学科疼痛治疗（IIPT）计划的反应，但尚无研究探讨完美主义的作用。这项二级数据分析探讨了IIPT后完美主义与功能障碍（主要结局）与疼痛严重程度（次级结局）之间的直接和间接关系，其中疼痛是灾难性的，并且对疼痛的担心是调解人。

方法 

在8-21岁之间患有慢性疼痛并伴有残疾的年轻人（N = 253）完成了IIPT之前和之后的自我导向完美主义（SOP），社会规定的完美主义（SPP），灾难性痛苦，对疼痛的恐惧，功能障碍，常规临床护理和该非随机试验的疼痛和疼痛特征。针对两个预测因素，两个中介因素和两个结果运行了八个中介模型。

结果 

预处理完美主义（SOP和SPP）可在IIPT过程中更大程度地减轻灾难性疼痛，从而降低疼痛的严重程度（SOP的β = -.02 [CI = -0.07，-0.01]，β = -.02 [ CI = -0.06，-0.003]为SPP）和功能少残疾（β = -.06 [CI = -0.13，-0.01]为SOP和β = -.06 [CI = -0.14，-0.01用于SPP） 。独立于疼痛灾难性治疗，SPP预处理与更多的治疗后功能障碍直接相关（β  = 0.16 [CI = 0.05，0.27]）。对痛苦的恐惧不是调解人。

结论 

研究结果表明，完美主义有可能对IIPT结果产生负面影响。但是，当患有慢性疼痛的完美主义青年学会处理与疼痛有关的困扰时，他们会受益。结果强调了评估和治疗慢性疼痛青年的完美主义和与疼痛相关的困扰的重要性。