METHODS: This topical review explored the extant literature in the areas of ToM and chronic pain, particularly for pediatric populations, with respect to biological, psychological, and social elements of the biopsychosocial model of pain.
RESULTS: ToM deficits may be present alongside previously identified biological, psychological, and social correlates of pediatric pain, as a vulnerability, mechanism, and/or consequence. Biologically, ToM deficits may relate to cortisol abnormalities and neurobiological substrates of pain processing. Psychologically, ToM deficits may stem from pain-focused cognitions, thus impacting relationships and fueling impairment. Socially, chronic pain may preclude normative development of ToM abilities through social withdrawal, thereby exacerbating the experience of pain.
CONCLUSIONS: Taken together, ToM deficits may be associated with increased risk for the development and/or maintenance of pediatric chronic pain, and pediatric chronic pain may similarly confer risk for ToM deficits. Future research should investigate the nature of ToM abilities in youth with chronic pain to test these hypotheses and ultimately inform ToM-focused and pain-based interventions, as this ability has been demonstrated to be modifiable.
方法:本主题综述探讨了ToM和慢性疼痛领域的现有文献,特别是对于儿科人群,关于生物学,心理,和疼痛的生物心理社会模型的社会因素。
结果:ToM缺陷可能与先前确定的生物学,心理,和儿科疼痛的社会相关因素,作为一种脆弱性,机制,和/或后果。生物学,ToM缺陷可能与皮质醇异常和疼痛处理的神经生物学底物有关。心理上,ToM缺陷可能源于以疼痛为中心的认知,从而影响关系并助长损害。社会上,慢性疼痛可能会通过社交退缩来阻碍ToM能力的规范发展,从而加剧了疼痛的体验。
结论:综合来看,ToM缺陷可能与儿童慢性疼痛发展和/或维持的风险增加有关。和小儿慢性疼痛可能同样会导致ToM缺陷的风险。未来的研究应该调查青少年慢性疼痛的ToM能力的性质,以测试这些假设,并最终告知以ToM为中心和基于疼痛的干预措施。因为这种能力已经被证明是可以修改的。