바로가기메뉴

본문 바로가기 주메뉴 바로가기

The Korean Journal of Health Psychology

  • KOREAN
  • P-ISSN1229-070X
  • E-ISSN2713-9581
  • KCI

Influence of Neuroticism and Pain Anxiety on Pain intensity: A Study on Patients with Degenerative Spondylitis and Arthritis

The Korean Journal of Health Psychology / The Korean Journal of Health Psychology, (P)1229-070X; (E)2713-9581
2017, v.22 no.2, pp.375-395
https://doi.org/10.17315/kjhp.2017.22.2.009



Abstract

This study was to examine the influence of psychological factors, such as neuroticism and pain anxiety, on the pain intensity in patients with degenerative spondylitis and arthritis, and to further identify a pathway of the psychological influences on pain intensity. Correlation and multiple regression analysis revealed that patients who reported a higher level of neuroticism and pain anxiety were more likely to experience higher level of pain intensity. Based on the Fear-Avoidance Model, a path analysis was conducted to identify a possible pathway that illustrates the influences of neuroticism and sub-categories (e.g. fearful thoughts, physiological arousal, pain avoidance behavior) of pain anxiety, on pain intensity. Results demonstrate that the suggested pathway appropriatelyexplains the relationships. The pathway shows that neuroticism directly influences fearful thoughts about pain, which in turn increase the physiological arousal and pain avoidance behavior, and these influence the pain intensity. Neuroticism also indirectly influences the pain intensity through sub-categories of pain anxiety. Fearful thoughts about pain have an indirect influence on pain intensity through physiological arousal and avoidance behavior. Physiological arousal directly influences the pain intensity. Lastly, we discuss the implications and limitations of this study, and suggestions for future research.

keywords
neuroticism, pain anxiety, pain intensity, fear-avoidance model, 통증 강도, 신경증 성향, 통증 불안, 공포-회피 모형

Reference

1.

강점덕 (2002). 통증과 불안의 관계분석. 대한정형물리치료학회지, 8(2), 19-29.

2.

김경운 (2010). 한국어판 Faces Pain Scale의 언어학적타당성 검증- 백혈병 아동을 대상으로. 한국모자보건학회지, 14(1), 74-82.

3.

김지현, 김복환, 하문선 (2011). 간편형 한국어 BFI(Big Five Inventory) 타당화 연구. 인간이해, 32(1), 47-65.

4.

김청송 (2003). 불안민감성에 따른 대학생 동통반응에서의 차이. 한국심리학회지: 임상, 22(2), 385-397.

5.

김청송, 유제민 (2000). 불안민감성이 동통 관련 도피 및 회피행동에 미치는 영향. 한국심리학회지: 건강, 5(1), 84-93.

6.

박경, 최순희 (1998). 류마티스 관절염 환자의 통증대처, 통증 및 우울정도의 관계. 류마티스 건강학회지, 5(2), 253-264.

7.

신재숙, 이봉건, 이혜경 (2014). 만성통증 환자의 수용과마음챙김이 재앙적 사고와 우울 및 통증에 미치는영향. 스트레스연구, 22(1), 11-21.

8.

신정원, 이인혜 (2003). 낙관주의 성향과 유도된 기분상태가 만성 통증 지각에 미치는 효과. 한국심리학회지: 건강, 8(3), 457-472.

9.

유성진, 신민섭, 김중술 (2003). 위협에 대한 재평가와걱정증상, 상태불안 및 인지평가차원의 관계. 한국심리학회지: 임상, 22(2), 303-319.

10.

이경석 (2005). 통증의 이해. 서울: 군자출판사

11.

이명숙 (2009). 일 도서지역 퇴행성관절염 환자의 삶의질, 지각된 건강상태, 통증 및 일상생활동작 장애. 농촌의학 지역보건학회지, 34(3), 291-302.

12.

진귀옥 (2008). 만성요통환자의 통증, 우울, 생활만족도에 관한 연구. 한양대학교 대학원 석사학위청구논문.

13.

현명호 (1997). 동통강도의 과대예측과 동통통제의 과소기대가 동통반응에 미치는 영향. 한국심리학회지:건강, 2(1), 186-208.

14.

홍세희, 유숙경 (2004). 다변량 고차 잠재 성장모형을이용한 내외통제성과 학업성취의 종단관계 분석. 교육평가연구, 17, 131-146.

15.

Asmundson, G. J., Norton, P. J., & Vlaeyen, J. W. (2004). Fear-avoidance models of chronic pain:An overview. In Asmundson, G. J., Vlaeyen, J. W., & Crombez, G. (Eds.), Understanding and treating fear of pain (pp. 3-24). Oxford: Oxford University Press.

16.

Bedson, J., & Croft, P. R. (2008). The discordance between clinical and radiographic knee osteoarthritis: A systematic search and summary of the literature. BMC Musculoskeletal Disorders, 9(1), 116.

17.

Brown, G. K., Nicassio, P. M., & Wallston, K. A. (1989). Pain coping strategies and depression in rheumatoid arthritis. Journal of Consulting and Clinical Psychology, 57(5), 652.

18.

Cho, S., Heiby, E. M., McCracken, L. M., Lee, S. M., & Moon, D. E. (2010). Pain-related anxiety as a mediator of the effects of mindfulness on physical and psychosocial functioning in chronic pain patients in Korea. The Journal of Pain, 11(8), 789–797.

19.

Cho, S., Lee, S., McCracken, L. M., Moon, D., & Heiby, E. M. (2010). Psychometric properties of a Korean version of the Pain Anxiety Symptoms Scale-20 in chronic pain patients. International Journal of Behavioral Medicine, 17(2), 108-125.

20.

Clark, D. A., & Beck, A. T. (1989). Cognitive theory and therapy of anxiety and depression. In P. C. Kendall & D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features (pp. 379-411). San Diego, CA: Academic Press.

21.

Caspi, A., & Shiner, R. L. (1998). Personality development. In Eisenberg, N. (Ed), Handbook of child psychology: Vol. 3: Social, emotinal, and prsonality development (pp. 300-365). New York.:Wiley & Sons, Inc.

22.

Flor, H., Birbaumer, N., Schugens, M. M., & Lutzenberger, W. (1992). Symptom‐Specific Psychophysiological Responses in Chronic Pain Patients. Psychophysiology, 29(4), 452-460.

23.

Glass, N. A., Torner, J. C., Law, L. F., Wang, K., Yang, T., Nevitt, M. C., ... Segal, N. A. (2013). The relationship between quadriceps muscle weakness and worsening of knee pain in the most cohort: A 5-year longitudinal study. Osteoarthritis and Cartilage, 21(9), 1154-1159.

24.

Goodwin, R. D., Cox, B. J., & Clara, I. (2006). Neuroticism and physical disorders among adults in the community: results from the National Comorbidity Survey. Journal of Behavioral Medicine, 29(3), 229-238.

25.

Goubert, L., Crombez, G., & Van Damme, S. (2004). The role of neuroticism, pain catastrophizing and pain-related fear in vigilance to pain: a structural equations approach. Pain, 107(3), 234-241.

26.

Grant, S. (2011). Neuroticism and cognitive appriasal. Neuroticism: The personality risk factor for stress and impaired health and well-being. (pp. 28-29). Hauppauge: Nova Science Publishers.

27.

John, O. P., & Srivastava, S. (1999). The Big Five trait taxonomy: History, measurement, and theoretical perspectives. Handbook of personality:Theory and research (pp. 102-138). New York:Guilford.

28.

Kim, E. J., & Buschmann, M. T. (2006). Reliability and validity of the Faces Pain Scale with older adults. International Journal of Nursing Studies, 43, 447-456.

29.

Kellgren, J. H., & Lawrence, J. S. (1957). Radiologic assessment of osteoarthrosis. Annals of The Rheumatic Diseases, 16, 494-502.

30.

Lahey, B. B. (2009). Public health significance of neuroticism. American Psychologist, 64(4), 241.

31.

Lee, Y. H., Lee, K. J., Han, G. S., Kim, H. K., Kim, J. H., & Kim, J. L. (2004). Suwon Longitudinal Aging Study (SLAS): Trends and Changes in Physical Functioning and Disability of Older Persons. Seoul, Korea: Ministry of Health &Welfare.

32.

Lipsey, M. W., & Wilson, D. B. (1993). The efficacy of psychological, educational, and behavioral treatment: Confirmation from meta-analysis. American Psychologist, 48(12), 1181.

33.

Mannion, A. F., Müntener, M., Taimela, S., & Dvorak, J. (2001). Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one‐year follow up. Rheumatology, 40(7), 772-778.

34.

McCrae, R. (2007). Aesthetic chills as a universal marker of openness to experience. Motivation and Emtion, 31(1), 5-11.

35.

McCrae, R., & Costa, P. (2008). The five-factor theory of personality in O. P. John, R. W. Robins, & L. A. Pervin (Eds.) Handbook of personality: Theory and research(3rd ed.)(pp. 159-180). New York: Guilford Press.

36.

McCracken, L. M., Carson, J. W., Eccleston, C., & Keefe, F. J. (2004). Acceptance and change in the context of chronic pain. Pain, 109(1-2), 4-7.

37.

McCracken, L. M., & Dhingra, L. (2002). A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Research and Management, 7(1), 45-50.

38.

McCracken, L. M., Gross, R. T., Sorg, P. J., & Edmands, T. A. (1993). Prediction of pain in patients with chronic low back pain: effects of inaccurate prediction and pain-related anxiety. Behaviour Research and Therapy, 31(7), 647-652.

39.

MacKinnon D. P., Lockwood C. M., & Williams J. (2004). Confidence limits for the indirect effect:Distribution of the product and resampling methods. Multivariate Behavioral Research 39, 99-128.

40.

Miro, J., Huguet, A., Nieto, R., Paredes, S., & Baos, J. (2005). Evaluation of Reliability, validity, and Preference for a pain intensity Scale for Use with Elderly. The Journal of Pain, 11, 727-735.

41.

Morley, S., Eccleston, C., & Williams, A. (1999). Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain, 80(1), 1-13.

42.

Pfirrmann, C. W., Metzdorf, A., Zanetti, M., Hodler, J., & Boos, N. (2001). Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine, 26(17), 1873-1878.

43.

Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior research methods, 40(3), 879-891.

44.

Quartana, P. J., Burns, J. W., & Lofland, K. R. (2007). Attentional strategy moderates effects of pain catastrophizing on symptom-specific physiological responses in chronic low back pain patients. Journal of behavioral medicine, 30(3), 221-231.

45.

Quartana, P. J., Campbell, C. M., & Edwards, R. R. (2009). Pain catastrophizing: A critical review. Expert Review of Neurotherapeutics, 9(5), 745-758.

46.

Robin, O., Vinard, H., Vernet-Maury, E., Saumet, J. L. (1987). Influence of sex and anxiety on pain threshold and tolerance. Functional Neurology, 2(2), 173-179.

47.

Severeijns, R., Vlaeyen, J. W., van den Hout, M. A., & Weber, W. E. (2001). Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. The Clinical Journal of Pain, 17(2), 165-172.

48.

Slemenda, C., Brandt, K. D., Heilman, D. K., Mazzuca, S., Braunstein, E. M., Katz, B. P., & Wolinsky, F. D. (1997). Quadriceps weakness and osteoarthritis of the knee. Annals of Internal Medicine, 127(2), 97-104.

49.

Stewart, A. L., Hays, R. D., Wells, K. B., Rogers, W. H., Spritzer, K. L., & Greenfield, S. (1994). Longterm functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the medical outcomes study. Journal of Clinical Epidemiology, 47, 719–730.

50.

Strahl, C., Kleinknecht, R. A., & Dinnel, D. L. (2000). The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning. Behaviour Research and Therapy, 38(9), 863-873.

51.

Taylor, S. (2005). Understanding and treating health anxiety: A cognitive-behavioral approach. Cognitive and Behavioral Practice, 11(1), 112-123.

52.

Taylor, S. E. (2014). 건강 심리학. (한수미, 이은아, 김현진 역). 서울: 학지사. (원전은 2009에 출판).

53.

Tolea, M. I., Terracciano, A., Simonsick, E. M., Metter, J., Costa Jr. P. T., & Ferrucci, L. (2012). Associations between personality traits, physical activity level, and muscle strength. Journal of Research in Personality, 46, 264–270.

54.

Turner, J. A., Holtzman, S., & Mancl, L. (2007). Mediators, moderators, and predictors of therapeutic change in cognitive–behavioral therapy for chronic pain. Pain, 127(3), 276-286.

55.

Vlaeyen, J. W. S., & Crombez, G. (1999). Fear of movement/(re) injury, avoidance and pain disability in chronic low back pain patients. Manual Therapy, 4(4), 187-195.

56.

Wullschleger, K. S., Lund, D. A., Caserta, M. S., & Wright, S. D. (1997). Anxiety about aging: A neglected dimension of caregivers' experiences. Journal of Gerontological Social Work, 26(3-4), 3-18.

The Korean Journal of Health Psychology