Cognitive Change and Relaxation as Key Mechanisms of Treatment Outcome in Chronic Pain: Evidence From Routine Care.
chronic pain
cognitive behavioral therapy
coping skills
effectiveness
mechanisms of change
multidisciplinary pain treatment
naturalistic
Journal
Frontiers in psychiatry
ISSN: 1664-0640
Titre abrégé: Front Psychiatry
Pays: Switzerland
ID NLM: 101545006
Informations de publication
Date de publication:
2021
2021
Historique:
received:
15
10
2020
accepted:
05
07
2021
entrez:
20
8
2021
pubmed:
21
8
2021
medline:
21
8
2021
Statut:
epublish
Résumé
Despite effective treatment approaches within the cognitive behavioral framework general treatment effects for chronic pain are rather small to very small. Translation from efficacy trials to naturalistic settings is questionable. There is an urgent need to improve the effectiveness of well-established treatments, such as cognitive-behavior therapy (CBT) and the investigation of mechanisms of change is a promising opportunity. We performed secondary data analysis from routine data of 1,440 chronic pain patients. Patients received CBT in a multidisciplinary setting in two inpatient clinics. Effect sizes and reliable change indices were computed for pain-related disability and depression. The associations between changes in the use of different pain coping skills (cognitive restructuring, activity despite pain, relaxation techniques and mental distraction) and changes in clinical outcomes were analyzed in structural equation models. Pre-post effect sizes range from
Identifiants
pubmed: 34413794
doi: 10.3389/fpsyt.2021.617871
pmc: PMC8368979
doi:
Types de publication
Journal Article
Langues
eng
Pagination
617871Informations de copyright
Copyright © 2021 Feldmann, Hein, Voderholzer, Doerr, Hoff, Langs, Herzog, Kaiser, Rief, Riecke and Brakemeier.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Arch Phys Med Rehabil. 2013 Apr;94(4 Suppl):S67-74
pubmed: 23465467
Pain. 2004 Mar;108(1-2):8-16
pubmed: 15109502
Lancet. 2011 Jun 25;377(9784):2226-35
pubmed: 21704872
Spine (Phila Pa 1976). 2013 Apr 20;38(9):E562-8
pubmed: 23388675
Psychol Health. 2009 Jun;24(5):545-61
pubmed: 20205011
J Pain. 2008 Sep;9(9):841-8
pubmed: 18550444
Behav Res Ther. 2008 Jun;46(6):701-14
pubmed: 18423571
Percept Mot Skills. 1984 Dec;59(3):974
pubmed: 6240632
Cogn Behav Ther. 2016;45(1):5-31
pubmed: 26818413
J Consult Clin Psychol. 2001 Aug;69(4):655-62
pubmed: 11550731
Lancet. 2018 Nov 24;392(10161):2299-2312
pubmed: 30396512
Cochrane Database Syst Rev. 2010 Jul 07;(7):CD002014
pubmed: 20614428
Pain. 1997 Jan;69(1-2):43-8
pubmed: 9060011
Borderline Personal Disord Emot Dysregul. 2017 May 21;4:8
pubmed: 28533905
J Cardiovasc Nurs. 2016 Sep-Oct;31(5):457-68
pubmed: 26065388
Spine (Phila Pa 1976). 2009 Dec 1;34(25):2803-9
pubmed: 19910868
Clin Psychol Eur. 2020 Jun 30;2(2):
pubmed: 34870201
Schmerz. 1994 Jun;8(2):100-10
pubmed: 18415443
Expert Rev Pharmacoecon Outcomes Res. 2006 Oct;6(5):591-601
pubmed: 20528505
Annu Rev Clin Psychol. 2007;3:1-27
pubmed: 17716046
Eur J Pain. 2004 Jun;8(3):211-9
pubmed: 15109971
Spine (Phila Pa 1976). 2000 Oct 15;25(20):2688-99
pubmed: 11034658
Cochrane Database Syst Rev. 2020 Aug 12;8:CD007407
pubmed: 32794606
J Pain. 2006 Apr;7(4):261-71
pubmed: 16618470
J Consult Clin Psychol. 1991 Feb;59(1):12-9
pubmed: 2002127
Lancet. 2005 Jan 1-7;365(9453):82-93
pubmed: 15639683
Pain. 2013 Oct;154(10):2108-2119
pubmed: 23806654
Lancet. 2016 Oct 8;388(10053):1545-1602
pubmed: 27733282
Pain. 1991 Jan;44(1):5-28
pubmed: 2038489
Eur J Pain. 2020 Sep;24(8):1495-1504
pubmed: 32548951
Curr Biol. 2012 Jun 5;22(11):1019-22
pubmed: 22608507
BMC Psychiatry. 2016 Feb 02;16:22
pubmed: 26831145
J Consult Clin Psychol. 2017 Jun;85(6):537-549
pubmed: 28394170
JAMA. 2007 Jan 24;297(4):403-6
pubmed: 17244837
Eur J Pain. 2008 Aug;12(6):722-30
pubmed: 18155934
Psychol Methods. 2020 Feb;25(1):30-45
pubmed: 31169371
J Health Psychol. 2010 Sep;15(6):935-47
pubmed: 20453049
BMC Public Health. 2013 Dec 24;13:1229
pubmed: 24365383
Pain. 2008 Feb;134(3):239-240
pubmed: 18164134
Schmerz. 2009 Feb;23(1):40-6
pubmed: 18941803
Top Spinal Cord Inj Rehabil. 2013 Fall;19(4):330-40
pubmed: 24244098
Pain. 2004 Jul;110(1-2):220-7
pubmed: 15275771
J Consult Clin Psychol. 2018 Jun;86(6):533-545
pubmed: 29781651
Qual Life Res. 2010 Dec;19(10):1457-65
pubmed: 20652418
J Affect Disord. 2004 Jul;81(1):61-6
pubmed: 15183601
Multivariate Behav Res. 2018 Nov-Dec;53(6):820-841
pubmed: 29624092
J Behav Med. 2010 Oct;33(5):335-45
pubmed: 20464629
J Dent Res. 2016 Apr;95(4):416-22
pubmed: 26758381
Eur J Pain. 2016 Jan;20(1):51-63
pubmed: 26031689
Cochrane Database Syst Rev. 2017 Jan 14;1:CD011279
pubmed: 28087891
Pain. 1984 Jul;19(3):209-233
pubmed: 6236417
J Pain. 2013 Mar;14(3):305-15
pubmed: 23352770
Ann Behav Med. 2007 Apr;33(2):179-88
pubmed: 17447870
Pain. 2016 Nov;157(11):2393-2394
pubmed: 27548048
Clin J Pain. 2010 Nov-Dec;26(9):747-53
pubmed: 20664333
Cogn Behav Ther. 2004;33(1):1-11
pubmed: 15224623
Mayo Clin Proc. 2015 Jan;90(1):139-47
pubmed: 25572198
Pain. 1999 Mar;80(1-2):1-13
pubmed: 10204712
Pain. 1995 Feb;60(2):203-216
pubmed: 7784106
Schmerz. 2015 Oct;29(5):550-6
pubmed: 26271912
Med Care. 2007 Oct;45(10 Supl 2):S50-7
pubmed: 17909384
Behav Res Ther. 2018 Sep;108:58-67
pubmed: 30031368
Psychother Res. 2021 Apr;31(4):468-482
pubmed: 32762508
Acta Anaesthesiol Scand. 2008 Jan;52(1):143-8
pubmed: 18005378
Pain. 1990 Feb;40(2):171-182
pubmed: 2308763
J Pain. 2009 May;10(5):493-500
pubmed: 19345153
Curr Pain Headache Rep. 2005 Apr;9(2):90-5
pubmed: 15745617
J Clin Rheumatol. 2012 Mar;18(2):76-82
pubmed: 22334270
Best Pract Res Clin Rheumatol. 2015 Feb;29(1):120-30
pubmed: 26267006
Annu Rev Psychol. 2009;60:577-605
pubmed: 18817479
Schmerz. 2009 Dec;23(6):609-17
pubmed: 19756770
Annu Rev Clin Psychol. 2011;7:411-34
pubmed: 21128783
J Pain. 2014 Aug;15(8):800-14
pubmed: 24878675
Rev Pain. 2010 Mar;4(1):18-22
pubmed: 26524978
Br J Anaesth. 2013 Jul;111(1):59-63
pubmed: 23794646
Clin J Pain. 2008 Mar-Apr;24(3):204-10
pubmed: 18287825
Pain. 2013 Oct;154(10):1929-1931
pubmed: 23742793
Schmerz. 2018 Feb;32(1):39-47
pubmed: 29270853
Med Care. 2010 Jun;48(6 Suppl):S17-22
pubmed: 20421825
Pain. 1999 Mar;80(1-2):329-39
pubmed: 10204746
Nurs Stand. 2008 Sep 17-23;23(2):35-41
pubmed: 18828292