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Cited by 174Musculoskeletal pain and rehabilitationPain Management and TreatmentPediatric Pain Management Techniques

Cognitive factors influence outcome following multidisciplinary chronic pain treatment: A replication and extension of a cross-lagged panel analysis

Burns, J.W., Glenn, B., Bruehl, S., Harden, R.N., Lofland, K.·2003·Behaviour Research and Therapy
DOI 10.1016/s0005-7967(03)00029-9
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Abstract

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.

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Crossref · 10.1016/s0005-7967(03)00029-9

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  • Relatively few treatment outcome studies have undertaken to measure and analyse possible mediators or change processes in chronic pain trials.

    “In fact, relatively few treatment outcome studies have undertaken to measure and analyse possible mediators 50, 51, 57 or changes processes 4-6, 19, 20, 45, 46 in chronic pain trials.”

    From The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain (2015) · cites this paper as [4]

  • A large number of psychological variables have been identified as potential CBT process variables, including pain beliefs, perceived control over pain, social support, coping, self-efficacy, helplessness, affective distress, and catastrophizing.

    “A large number of psychological variables have been identified as potential CBT process variables, including pain beliefs and perceived control over pain, 19, 20, 50 social support, 42, 43 coping, 19, 20 self-efficacy, 50 helplessness, 4-6 affective distress, and catastrophizing. 4, 6, 45, 46, 50, 52”

    From The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain (2015) · cites this paper as [4]

  • Previous investigations examining potential process variables in CBT approaches for chronic pain have focused largely on pain beliefs and perceived control over pain, social support, coping, self-efficacy, helplessness, affective distress, and catastrophizing.

    “Previous investigations examining potential process variables in CBT approaches for chronic pain have focused largely on pain beliefs and perceived control over pain, 19, 20, 50 social support, 42, 43 coping, 19, 20 self-efficacy, 50 helplessness, 4-6 affective distress, and catastrophizing. 4, 6, 45, 46, 50, 52”

    From The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain (2015) · cites this paper as [4]

  • Recent longitudinal studies in ongoing treatment programs have shown that decreases in catastrophizing that occur early in treatment predict decreases in pain and pain-related outcomes later in treatment.

    “Recent longitudinal studies, done in the context of ongoing treatment programs, have shown that decreases in catastrophizing that occur early in treatment predict decreases in pain and pain-related outcomes later in treatment.14,15”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [14]

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Authors
Burns, J. W., Glenn, B., Bruehl, S., Harden, R. N., & Lofland, K.
Affiliations
Shirley Ryan AbilityLab (US)
Corresponding author
Burns, J.W.
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2003-10
Volume
41
Issue
10
Pages
1163-1182
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/s0005-7967(03)00029-9
OpenAlex
W2033409514
Cited by
174
References
46
Citations by year
2026: 1 · 2025: 2 · 2024: 8 · 2023: 1 · 2022: 3 · 2021: 8 · 2020: 7 · 2019: 12 · 2018: 12 · 2017: 8 · 2016: 16 · 2015: 9 · 2014: 9 · 2013: 12 · 2012: 10
FWCI
3.40
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)
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
chronic pain, multidisciplinary pain program, cognitive behavioral therapy, pain catastrophizing, pain-related anxiety, maladaptive cognitions, pain interference, depression, pain intensity, treatment outcomes, replication
MeSH terms
Analysis of Variance, Anxiety, Attitude to Health, Chronic Disease, Cognition Disorders, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Pain, Regression Analysis, Cognitive Behavioral Therapy, Treatment Outcome, Pain Management

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