心理变量的聚类分析，以确定伤害性疼痛的概况：一项横断面研究，在妇女纤维肌痛，慢性头痛和外阴痛

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-06-25 DOI:10.1016/j.jpsychores.2025.112203

Filippo Maria Nimbi , Luigi Palla , Sara Bottiroli , Lorys Castelli , Piercarlo Sarzi-Puttini , Federica Galli

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引用次数: 0

摘要

背景伤害性疼痛（NP）是由伤害性加工过程的改变引起的，没有可检测到的组织损伤，在纤维肌痛（FM）、外阴痛（VU）和慢性头痛（CH）等疾病中很常见。目的采用聚类分析方法，根据中枢敏感综合征的表现、环境敏感性、创伤经历、人格特征、防御机制和述情障碍等心理变量，对NP患者进行亚群划分。第二个目的是比较这些群集与临床诊断（FM， CH， VU和合并症病例），以探索心理特征和条件之间潜在的重叠。方法通过患者协会采用滚雪球抽样方法，共招募895名意大利女性。参与者完成了一项网络调查，包括自我管理的心理测量，评估中心敏感性、环境敏感性、创伤经历、人格特征、防御机制和述情障碍。结果基于20个心理变量，聚类分析确定了三个有意义的群体——“严重”、“中度”和“轻度”心理障碍。单因素方差分析显示集群之间存在显著差异，中心敏化、述情障碍和人格特征对方差贡献最大。卡方分析显示，NP条件在集群间的分布存在显著差异。FM和合并症病例与“中度”和“重度”损害相关，表明与其他情况相比，心理状况更差。结论：这些发现强调了NP条件下存在不同的心理特征，支持了多维评估和治疗方法的必要性。针对这些特征的量身定制的心理干预可以改善NP患者的预后。

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A cluster analysis of psychological variables to identify profiles of Nociplastic pain: A cross-sectional study in women with fibromyalgia, chronic headache and vulvodynia

Background

Nociplastic pain (NP) arises from altered nociceptive processing without detectable tissue damage and is common in conditions such as fibromyalgia (FM), vulvodynia (VU), and chronic headaches (CH).

Objectives

This study aimed to identify subgroups of NP patients using cluster analysis based on psychological variables, including central sensitivity syndrome manifestations, environmental sensitivity, traumatic experiences, personality traits, defense mechanisms, and alexithymia. A secondary aim was to compare these clusters with clinical diagnoses (FM, CH, VU, and comorbid cases) to explore potential overlaps between psychological profiles and conditions.

Methods

A total of 895 Italian women were recruited via snowball sampling through patient associations. Participants completed a web survey featuring self-administered psychological measures assessing central sensitivity, environmental sensitivity, traumatic experiences, personality traits, defense mechanisms, and alexithymia.

Results

Cluster analysis identified three meaningful groups—“severe,” “moderate,” and “mild” psychological impairment—based on 20 psychological variables. A one-way MANOVA revealed significant differences among clusters, with central sensitization, alexithymia, and personality traits contributing most to the variance. Chi-square analysis showed significant differences in the distribution of NP conditions across clusters. FM and comorbid cases were associated with “moderate” and “severe” impairment clusters, indicating more compromised psychological profiles compared to other conditions.

Conclusions

These findings highlight the presence of distinct psychological profiles within NP conditions, supporting the need for a multidimensional approach to assessment and treatment. Tailored psychological interventions addressing these profiles could improve outcomes for NP patients.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.