Pain catastrophizing as a treatment process variable in cognitive behavioural therapy for adults with chronic pain
Open accessAbstract
BACKGROUND: Interdisciplinary cognitive behavioural therapy (CBT) for chronic pain is effective at improving function, mood and pain interference among individuals with disabling chronic pain. Traditionally, CBT assumes that cognitive change is an active therapeutic ingredient in the determination of treatment outcome. Pain catastrophizing, a cognitive response style that views the experience of pain as uncontrollable, permanent and destructive, has been identified as an important maladaptive cognition which contributes to difficulties with the management of chronic pain. Consequently, pain catastrophizing is commonly targeted in CBT for chronic pain. OBJECTIVES: To examine change trajectories in pain catastrophizing during treatment and assess the relevance of these trajectories to outcomes at posttreatment. METHODS: Participants included individuals with chronic pain (N = 463) who completed a 3-week program of interdisciplinary CBT. Pain catastrophizing was assessed weekly over the 3 weeks of treatment and latent growth curve modelling was used to identify trajectories of change. RESULTS: Findings indicated the presence of two classes of linear change, one with a significant negative slope in pain catastrophizing (i.e. improved class) and the other with a non-significant slope (i.e. unchanged class). Next, latent growth mixture modelling examined treatment outcome in relation to class membership. These results indicated that individuals in the 'improved' PCS class had significantly greater improvement in pain interference and mood, as well as physical and mental quality of life compared to the 'unchanged' class. CONCLUSIONS: Implications for our findings, in relation to the CBT model, are discussed.
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A single-session treatment is effective for modifying common cognitive features associated with emotional distress in chronic pain patients.
“In a similar light, it has been proven that a single-session treatment is effective for modifying common cognitive features associated with emotional distress in chronic pain patients [102,103,104].”
From A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders (2024) · cites this paper as [103]
The Participants section describes a three-week course of interdisciplinary CBT, not a single-session treatment. The conclusion reports reductions in pain catastrophizing, a cognitive feature, during that course. The paper therefore supports cognitive change in chronic pain patients but not the claimed effectiveness of a single session. (LLM, conf=0.88)
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- Authors
- Gilliam, W. P., Schumann, M. E., Cunningham, J. L., Evans, M. M., Luedtke, C. A., Morrison, E. J., Sperry, J. A., & Vowles, K. E.
- Affiliations
- Mayo Clinic (US)
- Queen's University Belfast (GB)
- Corresponding author
- Gilliam, Wesley P.
- ORCID
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2020-11-27
- Volume
- 25
- Issue
- 2
- Pages
- 339-347
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- OpenAlex
- W3091773633
- Cited by
- 51
- References
- 45
- Citations by year
- 2026: 10 · 2025: 11 · 2024: 12 · 2023: 8 · 2022: 6 · 2021: 4
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- green
- pure.qub.ac.uk
- Licence
- Locations
- European Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- pain catastrophizing, cognitive behavioral therapy, chronic pain, change trajectories, pain interference, mood, quality of life, multidisciplinary pain management
- MeSH terms
- Adult, Humans, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Catastrophization, Chronic Pain
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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