رابطة درد مزمن و فاجعه‌انگاری درد با شاخص تودة بدنی: نقش میانجی رفتارهای خوردن

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روانشناسی سلامت، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران

2 گروه روانشناسی، دانشگاه آزاد اسلامی، واحد آستارا، گیلان، ایران

3 گروه روانشناسی، واحد تهران مرکزی، دانشگاه آزاد اسلامی، تهران، ایران

چکیده

هدف: هدف از این مطالعه بررسی نقش میانجی رفتارهای خوردن در رابطة بین درد مزمن و فاجعه‌انگاری درد با شاخص تودة بدنی در افراد دارای درد مزمن بود. روش: روش پژوهش همبستگی و جامعة آماری زنان و مردان مبتلا به درد مزمن مراجعه‌کننده به بخش‌های ارتوپدی، فیزیوتراپی، مغز و اعصاب بیمارستان الغدیر و متخصصان ارتوپدی درمانگاه فرح‌بخش شهر تهران در بهار، تابستان، و پاییز 1398 بود که 400 نفر از آن­ها به روش نمونه‌گیری هدفمند انتخاب شده و در پژوهش شرکت کردند. داده‌ها با استفاده از محاسبة شاخص تودة بدنی شرکت‌کنندگان و پرسشنامه‌های رفتار خوردن داچ (فن‌اشتراین، فریجرز، برگرز و دیفارس، 1986)، درد مزمن (ون‌کورف و همکاران، 1990) و مقیاس فاجعه‌انگاری درد (سالیوان، بیشاپ و پیویک، 1995)، جمع‌آوری و با استفاد از مدل‌یابی معادلات ساختاری در نرم‌افزار Amos21 تحلیل شدند. یافته‌ها: نتایج نشان داد که مدل با داده‌های مشاهده­شده برازش مطلوب دارد (df2c 90/0و  RMSEA< 08/0). بررسی ضرایب مسیر نشان داد درد (303/0=β، 001/0P=) و فاجعه‌انگاری درد (149/0-=β، 001/0P=) اثر مستقیم معناداری بر شاخص تودة بدنی دارند. اثر غیرمستقیم درد (148/0=β، 001/0P=) و فاجعه‌انگاری درد (153/0=β، 001/0P=) بر شاخص تودة بدنی  معنادار است. درد مزمن، فاجعه‌انگاری درد و رفتارهای خوردن 5/30% از واریانس شاخص تودة بدنی را تبیین کردند. نتیجه‌گیری: تعامل بین تجربة درد و فاجعه­ انگاری درد با رفتارهای خوردن بر شاخص تودة بدنی تأثیر می­ گذارد.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between chronic pain and pain catastrophizing with body mass index: The mediating role of eating behaviors

نویسندگان [English]

  • mojgan khodapanah 1
  • sadegh taghiloo 2
  • fatemeh golshani 3
  • Anita baghdasarians 3
1 Department of Health Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
2 Department of Psychology, College of psychology, Astara Branch, Islamic Azad University, Guilan, Iran.
3 Department of Psychology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
چکیده [English]

Aim: To investigate the mediating role of eating behaviors in the relationship between chronic pain and pain catastrophizing with body mass index in people with chronic pain. Method: The research method was correlation. The sample (n = 400) were recruited through purposive sampling method from patients (males and females) with chronic pain who were visiting orthopedic, physiotherapy, neurology wards of Al-Ghadir Hospital and Farahbakhsh Clinic in Tehran in spring, summer and autumn of 2016. Participants' body mass index were collected, as well as, participants' responses on the Dutch Eating Behavior Questionnaire (VanStrien, Frijters, Bergers & Defares, 1986), Chronic Pain Questionnaire (VonKorff, Dworkin & Le Resche, 1990), and the Pain Catastrophizing Scale (Sullivan, Bishop & Pivik, 1995), then analyzed using structural equation modeling employing Amos software. Results: The results showed that the model has a good fit (df2c <3, GFI, AGFI and CFI> 0.90 and RMSEA <0.08). Examination of the path coefficients showed that pain (β = 0.303, P = 0.001; β = 0.148, P = 0.001) and pain catastrophizing (β = -0.149, P = 0.001; β = 0.153, P = 0.001) have a significant direct and indirect effect on body mass index, respectively. Furthermore, chronic pain, pain catastrophizing, and eating behaviors explained for 30.5% of the variance in body mass index. Conclusion: The interaction between pain experience and pain catastrophizing with eating behaviors affects body mass index.

کلیدواژه‌ها [English]

  • eating behaviors
  • chronic pain
  • pain catastrophizing
  • body mass index
قاسمی، وحید. (1392). مدل‌‌سازی معادله ساختاری در پژوهش‌های اجتماعی. تهران: جامعه‌شناسان.
شیرازی تهرانی، علیرضا.، میردریکوند، فضل‌اله و سپهوندی، محمدعلی. (1396). تدوین مدل ساختاری پیش‌بینی درد مزمن عضلانی-اسکلتی از طریق مهارت‌های مقابله‌ای، فاجعه‌آفرینی، ترس، شدت و ناتوانی درد. فصلنامه علمی پژوهشی بیهوشی و درد. 7 (4): 92-106. [پیوند]
صالحی فدردی، جواد؛ مداح شورچه، راحله؛ نعمتی، محسن (1390). مقایسه ی ساختار انگیزشی و سبکهای خوردن در زنان مبتلا به اضافه‌وزن و چاقیو دارای وزن طبیعی. مجله اصول بهداشت روانی، 13 (2): 81-170. [پیوند]
محمدی، سمیه.، دهقانی، محسن.، حیدری، محمود.، صداقت، مریم و خطیبی، علی. (۱۳۹۲). بررسی شباهت های روانشناختی مرتبط با درد در بیماران مبتلا به دردهای مزمن عضلانی – اسکلتی و همسران آن ها. مجله علوم رفتاری، ۷(1):۶۶-۵۷. [پیوند]
Abdallah, C. G., & Geha, P. (2017). Chronic pain and chronic stress: two sides of the same coin?. Chronic Stress, 1, 2470547017704763. [link]
Amy, E. A., & Kozak, A. T. (2012). “The more pain I have, the more I want to eat”: obesity in the context of chronic pain. Obesity, 20(10), 2027-2034. [link]
Bailly, N., Maitre, I., Amanda, M., Hervé, C., & Alaphilippe, D. (2012). The Dutch Eating Behaviour Questionnaire (DEBQ). Assessment of eating behaviour in an aging French population. Appetite59(3), 853-858. [link]
Benoit-Piau, J., Bergeron, S., Brassard, A., Dumoulin, C., Khalifé, S., Waddell, G., & Morin, M. (2018). Fear-avoidance and pelvic floor muscle function are associated with pain intensity in women with vulvodynia. The Clinical journal of pain, 34(9), 804-810. [Link]
Bigand, T., & Wilson, M. (2019). Overeating during painful episodes among adults with chronic pain: a preliminary study. Appetite, 137, 99-103. [Link]
Buchbinder, R., van Tulder, M., Öberg, B., Costa, L. M., Woolf, A., Schoene, M., ... & Maher, C. G. (2018). Low back pain: a call for action. The Lancet, 391(10137), 2384-2388. [link]
Caldwell, A. E., & Sayer, R. D. (2019). Evolutionary considerations on social status, eating behavior, and obesity. Appetite, 132, 238-248. [link]
Chisholm, A., Pearce, C. J., Chinoy, H., Warren, R. B., & Bundy, C. (2016). Distress, misperceptions, poor coping and suicidal ideation in psoriatic arthritis: a qualitative study. Rheumatology, 55(6), 1047-1052. [Link]
Clark, S., & Horton, R. (2018). Low back pain: a major global challenge. Lancet (London, England), 391(10137), 2302. [Link]
Darbor, K. E., Lench, H. C., & Carter-Sowell, A. R. (2016). Do people eat the pain away? The effects of acute physical pain on subsequent consumption of sweet-tasting food. PloS one, 11(11). [link]
Denke, G., Rawls, E., & Lamm, C. (2018). Attentional conflict moderates the association between anxiety and emotional eating behavior: An ERP Study. Frontiers in human neuroscience, 12, 194. [link]
Diggins, A., Woods-Giscombe, C., & Waters, S. (2015). The association of perceived stress, contextualized stress, and emotional eating with body mass index in college-aged Black women. Eating behaviors, 19, 188-192. [link]
Ebneter, D., Latner, J., Rosewall, J., & Chisholm, A. (2012). Impulsivity in restrained eaters: emotional and external eating are associated with attentional and motor impulsivity. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 17(1), e62-e65. [Link]
Emami, A. S., Woodcock, A., Swanson, H. E., Kapphahn, T., & Pulvers, K. (2016). Distress tolerance is linked to unhealthy eating through pain catastrophizing. Appetite, 107, 454-459. [link]
Fahrenkamp, A. J., Darling, K. E., Ruzicka, E. B., & Sato, A. F. (2019). Food Cravings and Eating: The Role of Experiential Avoidance. International journal of environmental research and public health, 16(7), 1181. [Link]
Felpeto, A., Ramos, A. M., Hincapie, D., Lenox, M. B., & Reinhardt, R. (2019). EATING THE PAIN AWAY: THE USE OF FOOD AS A COPING MECHANISM IN OLDER ADULTS EXPERIENCING CHRONIC PAIN. Innovation in Aging, 3(Supplement_1), S258-S258. [link]
Ferguson, S., Al-Rehany, L., Tang, C., Gougeon, L., Warwick, K., & Madill, J. (2013). Self-reported causes of weight gain: among prebariatric surgery patients. Canadian journal of dietetic practice and research, 74(4), 189-192. [Link]
Fritz, B. M., Muñoz, B., Yin, F., Bauchle, C., & Atwood, B. K. (2018). A high-fat, high-sugar ‘western’diet alters dorsal striatal glutamate, opioid, and dopamine transmission in mice. Neuroscience, 372, 1-15. [Link]
Godfrey, K. M., Bullock, A. J., Dorflinger, L. M., Min, K. M., Ruser, C. B., & Masheb, R. M. (2018). Pain and modifiable risk factors among weight loss seeking Veterans with overweight. Appetite, 128, 100-105. [link]
Hearon, B. A., Utschig, A. C., Smits, J. A., Moshier, S. J., & Otto, M. W. (2013). The role of anxiety sensitivity and eating expectancy in maladaptive eating behavior. Cognitive therapy and research, 37(5), 923-933. [Link]
Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological bulletin, 110(1), 86. [Link]
Homan, K., Sim, L., Crowley, S., & Harbeck-Weber, C. (2018). Eating attitudes test (EAT-26) factor structure and construct validity in adolescents with chronic pain. The Journal of Pain, 19(3), S56. [Link]
Janke, E. A., Jones, E., Hopkins, C. M., Ruggieri, M., & Hruska, A. (2016). Catastrophizing and anxiety sensitivity mediate the relationship between persistent pain and emotional eating. Appetite, 103, 64-71. [link]
Johansson, A. C., Gunnarsson, L. G., Linton, S. J., Bergkvist, L., Stridsberg, M., Nilsson, O., & Cornefjord, M. (2008). Pain, disability and coping reflected in the diurnal cortisol variability in patients scheduled for lumbar disc surgery. European Journal of Pain, 12(5), 633-640. [Link]
Jones, J., Kauffman, B. Y., Rosenfield, D., Smits, J. A., & Zvolensky, M. J. (2019). Emotion dysregulation and body mass index: The explanatory role of emotional eating among adult smokers. Eating behaviors, 33, 97-101. [Link]
Konttinen, H. (2020). Emotional eating and obesity in adults: the role of depression, sleep and genes. Proceedings of the Nutrition Society, 1-7. [link]
Leung, L. (2012). Pain catastrophizing: an updated review. Indian journal of psychological medicine, 34(3), 204. [link]
Lopes, M. F. F. (2020). Obesity and Related Diseases. In Gastric Bypass (pp. 31-40). Springer, Cham. [Link]
Martins, L. B., Monteze, N. M., Calarge, C., Ferreira, A. V. M., & Teixeira, A. L. (2019). Pathways linking obesity to neuropsychiatric disorders. Nutrition, 66, 16-21. [Link]
Masheb, R. M., Douglas, M. E., Kutz, A. M., Marsh, A. G., & Driscoll, M. (2020). Pain and emotional eating: further investigation of the Yale Emotional Overeating Questionnaire in weight loss seeking patients. Journal of Behavioral Medicine, 1-8. [link]
McVinnie, D. S. (2013). Obesity and pain. British journal of pain, 7(4), 163-170. [Link]
Meleger, A. L., Froude, C. K., & Walker III, J. (2014). Nutrition and eating behavior in patients with chronic pain receiving long-term opioid therapy. PM&R, 6(1), 7-12. [Link]
Narouze, S., & Souzdalnitski, D. (2015). Obesity and chronic pain: systematic review of prevalence and implications for pain practice. [Link]
Okifuji, A., & Hare, B. D. (2015). The association between chronic pain and obesity. Journal of Pain Research, 8, 399–408. [Link]
O'Loughlin, I., & Newton-John, T. R. (2019). ‘Dis-comfort eating’: An investigation into the use of food as a coping strategy for the management of chronic pain. Appetite, 140, 288-297. [link]
Pickett, S., McCoy, T. P., & Odetola, L. (2020). The Influence of Chronic Stress and Emotions on Eating Behavior Patterns and Weight among Young African American Women. Western Journal of Nursing Research, 0193945919897541. [Link]
Price, R. C., Christou, N. V., Backman, S. B., Stone, L., & Schweinhardt, P. (2016). Opioid-receptor antagonism increases pain and decreases pleasure in obese and non-obese individuals. Psychopharmacology, 233(23-24), 3869-3879. [Link]
Sim, L. A., Lebow, J., Weiss, K., Harrison, T., & Bruce, B. (2017). Eating disorders in adolescents with chronic pain. Journal of Pediatric Health Care, 31(1), 67-74. [Link]
Somers, T. J., Wren, A. A., Blumenthal, J. A., Caldwell, D., Huffman, K. M., & Keefe, F. J. (2014). Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter?. JCR: Journal of Clinical Rheumatology, 20(5), 244-250. [link]
Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: development and validation. Psychological assessment, 7(4), 524. [link]
Tomiyama, A. J., Dallman, M. F., & Epel, E. S. (2011). Comfort food is comforting to those most stressed: evidence of the chronic stress response network in high stress women. Psychoneuroendocrinology, 36(10), 1513-1519. [Link]
Treede, R. D. (2018). The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. Pain reports, 3(2). [Link]
Tumin, D., Frech, A., Lynch, J. L., Raman, V. T., Bhalla, T., & Tobias, J. D. (2020). Weight gain trajectory and pain interference in young adulthood: Evidence from a longitudinal birth cohort study. Pain Medicine, 21(3), 439-447. [Link]
Van Strien, T., Frijters, J. E., Bergers, G. P., & Defares, P. B. (1986). The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International journal of eating disorders, 5(2), 295-315. [Link]
Verbunt, J. A., Seelen, H. A., Vlaeyen, J. W., van de Heijden, G. J., Heuts, P. H., Pons, K., & Knottnerus, J. A. (2003). Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. European journal of pain, 7(1), 9-21. [Link]
Von Korff, M., Dworkin, S. F., & Le Resche, L. (1990). Graded chronic pain status: an epidemiologic evaluation. Pain, 40(3), 279-291. [Link]
Wong, W. S., & Fielding, R. (2012). The co-morbidity of chronic pain, insomnia, and fatigue in the general adult population of Hong Kong: Prevalence and associated factors. Journal of psychosomatic research, 73(1), 28-34. [link]
Yousif, M. M., Kaddam, L. A., & Humeda, H. S. (2019). Correlation between physical activity, eating behavior and obesity among Sudanese medical students Sudan. BMC Nutrition, 5(1), 6. [link