TY - JOUR
T1 - Cognitive factors influence outcome following multidisciplinary chronic pain treatment
T2 - A replication and extension of a cross-lagged panel analysis
AU - Burns, J. W.
AU - Glenn, B.
AU - Bruehl, S.
AU - Harden, Robert N
AU - Lofland, K.
PY - 2003/10/1
Y1 - 2003/10/1
N2 - Reducing maladaptive cognitions is hypothesized to constitute an active therapeutic process in multidisciplinary pain programs featuring cognitive-behavioral interventions. A cross-lagged panel design was used to determine whether: a) early-treatment cognitive changes predicted late-treatment pain, interference, activity and mood changes, but not vice versa; b) three cognitive factors made unique contributions to outcome; c) substantial cognitive changes preceded substantial improvements in outcome. Sixty-five chronic pain patients, participating in a 4-week multidisciplinary program, completed measures of pain helplessness, catastrophizing, pain-related anxiety (process factors), pain severity, interference, activity level and depression (outcomes) at pre-, mid- and posttreatment. Results showed that early-treatment reductions in pain helplessness predicted late-treatment decreases in pain and interference, but not vice versa, and that early-treatment reductions in catastrophizing and pain-related anxiety predicted late-treatment improvements in pain severity, but not vice versa. Findings suggested that the three process factors predicted improvements mostly in common. However, little evidence was found that large early-treatment reductions in process variables preceded extensive improvements in pain. Findings replicate those of a recent report regarding cross-lagged effects, and offer support that cognitive changes may indeed influence late-treatment changes in outcomes.
AB - Reducing maladaptive cognitions is hypothesized to constitute an active therapeutic process in multidisciplinary pain programs featuring cognitive-behavioral interventions. A cross-lagged panel design was used to determine whether: a) early-treatment cognitive changes predicted late-treatment pain, interference, activity and mood changes, but not vice versa; b) three cognitive factors made unique contributions to outcome; c) substantial cognitive changes preceded substantial improvements in outcome. Sixty-five chronic pain patients, participating in a 4-week multidisciplinary program, completed measures of pain helplessness, catastrophizing, pain-related anxiety (process factors), pain severity, interference, activity level and depression (outcomes) at pre-, mid- and posttreatment. Results showed that early-treatment reductions in pain helplessness predicted late-treatment decreases in pain and interference, but not vice versa, and that early-treatment reductions in catastrophizing and pain-related anxiety predicted late-treatment improvements in pain severity, but not vice versa. Findings suggested that the three process factors predicted improvements mostly in common. However, little evidence was found that large early-treatment reductions in process variables preceded extensive improvements in pain. Findings replicate those of a recent report regarding cross-lagged effects, and offer support that cognitive changes may indeed influence late-treatment changes in outcomes.
KW - Chronic pain
KW - Cross-legged analysis
KW - Outcome
KW - Process
UR - http://www.scopus.com/inward/record.url?scp=0041825573&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0041825573&partnerID=8YFLogxK
U2 - 10.1016/S0005-7967(03)00029-9
DO - 10.1016/S0005-7967(03)00029-9
M3 - Article
C2 - 12971938
AN - SCOPUS:0041825573
VL - 41
SP - 1163
EP - 1182
JO - Behaviour Research and Therapy
JF - Behaviour Research and Therapy
SN - 0005-7967
IS - 10
ER -