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Cited by 31Musculoskeletal pain and rehabilitationAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychotherapy Techniques and Applications

Both early and late changes in psychological variables relate to treatment outcome for musculoskeletal pain patients at risk for disability

Bergbom, Sofia, Boersma, Katja, Linton, Steven J.·2012·Behaviour Research and Therapy
DOI 10.1016/j.brat.2012.08.008
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Abstract

We know little about why some people get better after psychological treatments for pain disability, whereas other people do not. In order to understand differences in treatment response, we need to explore processes of change during treatment. It has been suggested that people with pain complaints who change early in treatment have better outcomes. Therefore, we aimed to investigate whether changes in psychological variables at different time points are related to outcome, and whether early or late changes are better predictors of outcome. We used the fear avoidance model as a theoretical framework. We followed 64 patients weekly over 6-7 weeks and then determined outcome. Our findings indicate that people who decrease in catastrophizing and function early in treatment as well as in depressive symptoms, worry, fear avoidance beliefs and function late in treatment have better outcomes. Early decreases in function, and late decreases in depressive symptoms and worry uniquely predict improvements in disability. While early and late changes covaried concurrently, there were no significant sequential relationships between early and late changes. Changes in the proposed process variables in the fear avoidance model, early as well as late in treatment, thus add valuable information to the explanation of outcome.

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  • A second category of mechanistic study delivers a pain-related intervention intended to change a psychological factor, with the expectation that changing that psychosocial factor will be associated with later change in pain-related outcomes.

    “The second category of mechanistic study involves delivery of some type of pain-related intervention that is hypothesized to directly affect a psychological factor, presuming that changing that psychosocial factor (e.g., reducing distress, improving pain-coping, etc) will be associated with a subsequent change in one or more pain-related outcomes.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [31]

  • In such intervention studies, the psychological factor acts as a mediator, not necessarily a causal mechanism, through which treatment benefits occur.

    “That is, the psychological factor acts as a mediator (though not necessarily a causal mechanism) through which a treatment confers its benefits 30, 31.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [31]

  • Early-treatment changes in catastrophizing account for substantial portions of variability in end-of-treatment outcomes.

    “There is also evidence suggesting that substantial portions of the variability in end-of-treatment outcomes can be accounted for by early-treatment changes in catastrophizing 30, 31.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [31]

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Authors
Bergbom, S., Boersma, K., & Linton, S. J.
Affiliations
Örebro University (SE)
Corresponding author
Bergbom, Sofia
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2012-11
Volume
50
Issue
11
Pages
726-734
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2012.08.008
OpenAlex
W2059475286
Cited by
31
References
41
Citations by year
2026: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 6 · 2016: 1 · 2015: 2 · 2014: 4 · 2013: 3
FWCI
2.12
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
Funders
Forskningsrådet för Arbetsliv och Socialvetenskap
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
musculoskeletal pain, pain-related disability, treatment outcome prediction, fear-avoidance beliefs, pain catastrophizing, depressive symptoms, worry, functions, change processes
MeSH terms
Anxiety, Avoidance Learning, Conditioning, Operant, Depression, Disability Evaluation, Fear, Female, Humans, Implosive Therapy, Male, Middle Aged, Models, Psychological, Surveys and Questionnaires, Severity of Illness Index, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Catastrophization, Musculoskeletal Pain

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