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首页> 外文期刊>Cognitive Behaviour Therapy >Can Exposure and Acceptance Strategies Improve Functioning and Life Satisfaction in People with Chronic Pain and Whiplash-Associated Disorders (WAD)? A Randomized Controlled Trial
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Can Exposure and Acceptance Strategies Improve Functioning and Life Satisfaction in People with Chronic Pain and Whiplash-Associated Disorders (WAD)? A Randomized Controlled Trial

机译：暴露和接受策略能否改善慢性疼痛和鞭打相关疾病（WAD）患者的功能和生活满意度？随机对照试验

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Although 14% to 42% of people with whiplash injuries end up with chronic debilitating pain, there is still a paucity of empirically supported treatments for this group of patients. In chronic pain management, there is increasing consensus regarding the importance of a behavioural medicine approach to symptoms and disability. Cognitive behaviour therapy has proven to be beneficial in the treatment of chronic pain. An approach that promotes acceptance of, or willingness to experience, pain and other associated negative private events (e.g. fear, anxiety, and fatigue) instead of reducing or controlling symptoms has received increasing attention. Although the empirical support for treatments emphasizing exposure and acceptance (such as acceptance and commitment therapy) is growing, there is clearly a need for more outcome studies, especially randomized controlled trials. In this study, participants (N = 21) with chronic pain and whiplash-associated disorders were recruited from a patient organization and randomized to either a treatment or a wait-list control condition. Both groups continued to receive treatment as usual. In the experimental condition, a learning theory framework was applied to the analysis and treatment. The intervention consisted of a 10-session protocol emphasizing values-based exposure and acceptance strategies to improve functioning and life satisfaction by increasing the participants' abilities to behave in accordance with values in the presence of interfering pain and distress (psychological flexibility). After treatment, significant differences in favor of the treatment group were seen in pain disability, life satisfaction, fear of movements, depression, and psychological inflexibility. No change for any of the groups was seen in pain intensity. Improvements in the treatment group were maintained at 7-month follow-up. The authors discuss implications of these findings and offer suggestions for further research in this area.
机译：尽管有14％到42％的鞭打伤患者最终会出现慢性衰弱性疼痛，但对于这类患者，仍缺乏经验支持的治疗方法。在慢性疼痛管理中，关于行为医学方法对症状和残疾的重要性的共识越来越多。认知行为疗法已被证明对慢性疼痛的治疗有益。促进对疼痛和其他相关的负面私人事件（例如恐惧，焦虑和疲劳）的接受或愿意经历的方法，而不是减轻或控制症状的方法，已受到越来越多的关注。尽管强调暴露和接受（例如接受和承诺治疗）治疗的经验支持正在增长，但是显然需要更多的结局研究，尤其是随机对照试验。在这项研究中，从患者组织中招募了患有慢性疼痛和与鞭打相关疾病的参与者（N = 21），并随机分配至治疗或等待名单控制条件。两组均照常接受治疗。在实验条件下，将学习理论框架应用于分析和处理。干预措施包括10个疗程的协议，该协议强调基于值的暴露和接受策略，以通过增加参与者在存在干扰和痛苦的情况下根据值进行行为的能力（心理灵活性）来改善功能和生活满意度。治疗后，在疼痛残疾，生活满意度，对运动的恐惧，沮丧和心理僵硬方面，发现对治疗组有利的显着差异。两组的疼痛强度均无变化。治疗组的改善在随访7个月时得以维持。作者讨论了这些发现的含义，并为该领域的进一步研究提供了建议。

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