Role of affective instability on suicidal risk in complex regional pain syndrome: a diary approach (preliminary report)
0
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background: Many patients with complex regional pain syndrome (CRPS) have been known to be at risk of suicide, due to severe pain and its comorbid conditions. The risk of suicide may be associated with affective instability, which is an indicator of emotional dysregulation. Particularly, unstable shifts in negative emotions are difficult to cope with, which may result in individuals feeling uncontrollable, hopeless, and entrapped. This study aimed to examine the role of affective instability in the relationship between pain intensity and suicide risk (suicidal ideation and impulsivity) in patients with CRPS, by employing a daily diary. Methods: Twenty-three patients registered at the CRPS Association in Korea were asked to complete a day-to-day routine for 15 days, followed by a diary composed of pain intensity, suicidal ideation, impulsivity, and positive and negative affects. Results: Results showed that the interactions between negative affective instability and daily pain intensity were statistically significant on daily suicidal ideation (coefficient = 0.41, t (21) = 2.56, P < 0.050) and daily impulsiveness (coefficient = 1.20, t (19) = 3.35, P < 0.010). However, those between positive affective instability and daily pain intensity were not. Conclusions: This study is the first attempt to investigate the role of affective instability on the relationship between daily pain intensity and daily suicide risk in patients with CRPS. Our findings suggest that health professionals pay considerable attention to the instability of negative affects when assessing and managing patients with CRPS at risk of suicide.
Abstract
Background: Many patients with complex regional pain syndrome (CRPS) have been known to be at risk of suicide, due to severe pain and its comorbid conditions. The risk of suicide may be associated with affective instability, which is an indicator of emotional dysregulation. Particularly, unstable shifts in negative emotions are difficult to cope with, which may result in individuals feeling uncontrollable, hopeless, and entrapped. This study aimed to examine the role of affective instability in the relationship between pain intensity and suicide risk (suicidal ideation and impulsivity) in patients with CRPS, by employing a daily diary. Methods: Twenty-three patients registered at the CRPS Association in Korea were asked to complete a day-to-day routine for 15 days, followed by a diary composed of pain intensity, suicidal ideation, impulsivity, and positive and negative affects. Results: Results showed that the interactions between negative affective instability and daily pain intensity were statistically significant on daily suicidal ideation (coefficient = 0.41, t (21) = 2.56, P < 0.050) and daily impulsiveness (coefficient = 1.20, t (19) = 3.35, P < 0.010). However, those between positive affective instability and daily pain intensity were not. Conclusions: This study is the first attempt to investigate the role of affective instability on the relationship between daily pain intensity and daily suicide risk in patients with CRPS. Our findings suggest that health professionals pay considerable attention to the instability of negative affects when assessing and managing patients with CRPS at risk of suicide.
참고문헌 (45)
- de Mos M, "The incidence of complex regional pain syndrome : a population-based study", Pain, 129, pp.12~20 (2007)
- Albazaz R, "Complex regional pain syndrome : a review", Ann Vasc Surg, 22, pp.297~306 (2008)
- Ciccone DS, "Psychological dysfunction in patients with reflex sympathetic dystrophy", Pain, 71, pp.323~333 (1997)
- Bruehl S, "Psychological differences between reflex sympathetic dystrophy and non-RSD chronic pain patients", Pain, 67, pp.107~114 (1996)
- Hardy MA, "Psychological evaluation and pain assessment in patients with reflex sympathetic dystrophy", J Hand Ther, 1, pp.155~164 (1988)
- Edwards RR, "Painrelated catastrophizing as a risk factor for suicidal ideation in chronic pain", Pain, 126, pp.272~279 (2006)
- Sharma A, "A web-based crosssectional epidemiological survey of complex regional pain syndrome", Reg Anesth Pain Med, 34, pp.110~115 (2009)
- Kamen C, "Affective lability:separable from neuroticism and the other big four?", Psychiatry Res, 176, pp.202~207 (2010)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2000), American Psychiatric Association
- McConville C, "Personality correlates of variable moods", Pers Individ Dif, 26, pp.65~78 (1998)
- Taylor VA, "The effects of glucocorticoids on the inhibition of emotional information : a dose-response study", Biol Psychol, 86, pp.17~25 (2011)
- Taylor VA, "Impact of mindfulness on the neural responses to emotional pictures in experienced and beginner meditators", Neuroimage, 57, pp.1524~1533 (2011)
- Palmier-Claus JE, "Does unstable mood increase risk of suicide? Theory, research and practice", J Affect Disord, 143, pp.5~15 (2012)
- Merskey H, "Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms" (1994), IASP press
- Astifidis RP, "Fundamentals of hand therapy: clinical reasoning and treatment guidelines for common diagnoses of the upper extremity", pp.37~ (2007), Mosby Elsevier
- Rost S, "Affective instability in patients with chronic pain : a diary approach", Pain, 157, pp.1783~1790 (2016)
- Links PS, "Elements of affective instability associated with suicidal behaviour in patients with borderline personality disorder", Can J Psychiatry, 53, pp.112~116 (2008)
- Trull TJ, "Affective instability : measuring a core feature of borderline personality disorder with ecological momentary assessment", J Abnorm Psychol, 117, pp.647~661 (2008)
- Oh SM, "A study on the standardization of the Hospital Anxiety and Depression Scale for Koreans : a comparison of normal, depressed and anxious groups", J Korean Neuropsychiatr Assoc, 38, pp.289~296 (1999)
- Bjelland I, "The validity of the Hospital Anxiety and Depression Scale. An updated literature review", J Psychosom Res, 52, pp.69~77 (2002)
- Shin MS, "A study of suicidal ideation among high school students : the structural relation among depression, hopelessness, and suicidal ideation", Korean J Clin Psychol, 9, pp.1~19 (1990)
- Beck AT, "Assessment of suicidal intention : the Scale for Suicide Ideation", J Consult Clin Psychol, 47, pp.343~352 (1979)
- 허심양, "한국판 Barratt 충동성 검사-11의 신뢰도 및 타당도 연구", 한국심리학회지:일반, 31(3), pp.769~782 (2012), 한국심리학회
- Patton JH, "Factor structure of the Barratt impulsiveness scale", J Clin Psychol, 51, pp.768~774 (1995)
- Diener E, "The independence of positive and negative affect", J Pers Soc Psychol, 47, pp.1105~1117 (1984)
- 임선영, "한국판 다차원적 충동성 척도(UPPS-P)의 타당화 연구: 대학생 집단을 대상으로", Korean Journal of Clinical Psychology, 33(1), pp.51~71 (2014), 한국임상심리학회[DOI]
- Whiteside SP, "The Five Factor Model and impulsivity : using a structural model of personality to understand impulsivity", Pers Individ Dif, 30, pp.669~689 (2001)
- 최미란, "우울과 정서 불안정성: 분산, 자기상관 및 계차제곱평균의 비교", Korean Journal of Clinical Psychology, 35(4), pp.747~757 (2016), 한국임상심리학회[DOI]
- Hofmann DA, "Multilevel theory, research, and methods in organizations:foundations, extensions, and new directions", pp.467~511 (2000), Jossey-Bass
- Littell RC, "SAS system for mixed models" (1996), SAS Institute
- Raudenbush SW, "Hierarchical linear models: applications and data analysis methods" (2002), Sage
- McMahon SB, "Wall &Melzack’s textbook of pain: expert consult - online" (2013), Elsevier Health Sciences UK
- Carpenter RW, "Components of emotion dysregulation in borderline personality disorder : a review", Curr Psychiatry Rep, 15, pp.335~ (2013)
- Sebastin SJ, "Complex regional pain syndrome", Indian J Plast Surg, 44, pp.298~307 (2011)
- Riquino MR, "Emotion dysregulation as a transdiagnostic mechanism of opioid misuse and suicidality among chronic pain patients", Borderline Personal Disord Emot Dysregul, 5, pp.11~ (2018)
- Hamilton NA, "Affect and pain in rheumatoid arthritis: do individual differences in affective regulation and affective intensity predict emotional recovery from pain?", Ann Behav Med, 29, pp.216~224 (2005)
- Mennin DS, "Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder", Behav Res Ther, 43, pp.1281~1310 (2005)
- Gross JJ, "Emotion regulation : affective, cognitive, and social consequences", Psychophysiology, 39, pp.281~291 (2002)
- 황성훈, "한국판 정서적 불안정성 척도-단축판의 타당화", Korean Journal of Clinical Psychology, 34(3), pp.625~648 (2015), 한국임상심리학회[DOI]
- Kosciw JG, "The 2011 National School Climate Survey: the experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools" (2012), GLSEN
- Bowen R, "Mood variability in anxiety disorders", J Affect Disord, 91, pp.165~170 (2006)
- Coccaro EF, "Development of neuropharmacologically based behavioral assessments of impulsive aggressive behavior", J Neuropsychiatry Clin Neurosci, 3, pp.S44~51 (1991)
- Koenigsberg HW, "Are the interpersonal and identity disturbances in the borderline personality disorder criteria linked to the traits of affective instability and impulsivity?", J Pers Disord, 15, pp.358~370 (2001)
- Berking M, "Handbook of emotion regulation", pp.529~547 (2014), Guilford Publications
- Speck V, "Increased prevalence of posttraumatic stress disorder in CRPS", Eur J Pain, 21, pp.466~473 (2017)