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

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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

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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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Authors: Burns, J. W., Glenn, B., Bruehl, S., Harden, R. N., & Lofland, K.
Affiliations: Shirley Ryan AbilityLab (US)
Corresponding author: Burns, J.W.
ORCID: Burns, J.W.
Glenn, B.
Bruehl, S.
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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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Cognitive factors influence outcome following multidisciplinary chronic pain treatment: a replication and extension of a cross-lagged panel analysis

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