Is reduction in pain catastrophizing a therapeutic mechanism specific to cognitive-behavioral therapy for chronic pain?
Open accessAbstract
Mechanisms underlying favorable outcomes of psychosocial interventions for chronic pain are unclear. Theory suggests changes in maladaptive cognitions represent therapeutic mechanisms specific to cognitive-behavioral therapy (CBT). We illustrate the importance of examining whether treatments work either uniquely via mechanisms specified by theory or via mechanisms common to different treatments. Secondary data analysis was conducted to examine the effects of reduction in pain catastrophizing on outcomes following CBT and Pain Education. Generally, reductions in pain catastrophizing were significantly related to outcome improvements irrespective of CBT or Pain Education condition. Results underscore the need to assess whether mechanisms presumed to operate specifically in one treatment do indeed predict outcomes and illustrate the importance of broadening the assessment of mechanisms beyond those specified by theory. Theory-specific, competing, and common mechanisms must all be assessed to determine why our treatments work.
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Catastrophising is a process variable rather than an outcome variable.
“we agree with current thinking about catastrophising that it is a process variable rather than an outcome variable (Burns 2012)”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2020) · cites this paper as Burns 2012
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- Authors
- Burns, J. W., Day, M. A., & Thorn, B. E.
- Affiliations
- Rush University Medical Center (US)
- University of Alabama (US)
- Corresponding author
- Thorn, Beverly E
- Venue
- Translational Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-11-22
- Volume
- 2
- Issue
- 1
- Pages
- 22-29
- ISSN
- 1613-9860 (ISSN-L)
- 1869-6716
- PMC
- PMC3717814
- OpenAlex
- W1996201879
- Cited by
- 112
- References
- 65
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 11 · 2023: 13 · 2022: 4 · 2021: 9 · 2020: 13 · 2019: 11 · 2018: 5 · 2017: 5 · 2016: 9 · 2015: 4 · 2014: 4 · 2013: 4 · 2012: 2
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Translational Behavioral Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- pain catastrophizing, cognitive behavioral therapy, chronic pain, pain education, therapeutic mechanisms, maladaptive cognitions, psychosocial interventions, common mechanisms
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