Cognitive mechanisms of change in multidisciplinary treatment of patients with chronic widespread pain: a prospective cohort study
Open accessAbstract
OBJECTIVE: To evaluate the contribution of improvement in negative emotional cognitions, active cognitive coping, and control and chronicity beliefs to the outcome of multidisciplinary treatment in patients with chronic widespread pain. DESIGN: Prospective cohort study. PATIENTS: A total of 120 subjects diagnosed with chronic widespread pain, who completed a multidisciplinary pain programme. METHODS: Data from baseline, 6 months and 18 months follow-up measurements were analysed. Longitudinal relationships were analysed between changes in cognitions and outcome, using generalized estimated equations. Outcome domains included: pain, interference of pain in daily life, depression, and global perceived effect. Cognitive domains included: negative emotional cognitions, active cognitive coping and control and chronicity beliefs. RESULTS: Improvements in negative emotional cognitions were associated with improvements in all outcome domains, in particular with improvement in interference of pain with daily life and depression (between baseline and 6 months, and 6 and 18 months). Improvements in active cognitive coping were associated with improvements in interference of pain in daily life (between baseline and 6 months). Improvements in control and chronicity beliefs were associated with improvements in pain and depression (between 6 and 18 months). CONCLUSION: Improvement in negative emotional cognitions seems to be a key mechanism of change in multidisciplinary treatment of chronic widespread pain. Improvement in active cognitive coping and improvement in control and chronic timeline beliefs may also constitute mechanisms of change, although the evidence is less strong.
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PTSD symptoms mediate the relationship between childhood abuse and maltreatment and later-life pain and pain-related limitations.
“PTSD symptoms have been shown to mediate the relationship between childhood abuse and maltreatment and pain and pain-related limitations later in life 75, 76.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [76]
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- Authors
- Rooij, A., Boer, M., Leeden, M., Roorda, L., Steultjens, M., & Dekker, J.
- Affiliations
- Reade (NL)
- Vrije Universiteit Amsterdam (NL)
- Glasgow Caledonian University (GB)
- Venue
- Journal of Rehabilitation Medicine
- Published
- 2014
- Volume
- 46
- Issue
- 2
- Pages
- 173-180
- ISSN
- 1650-1977 (ISSN-L)
- OpenAlex
- W2140989493
- Cited by
- 26
- References
- 36
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 7 · 2015: 1 · 2014: 1
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Rehabilitation Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- VU Research Portal (publishedVersion, other-oa)
- ResearchOnline (Glasgow Caledonian University) (acceptedVersion, cc-by-nc)
- ResearchOnline (submittedVersion, cc-by-nc)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic widespread pain, multidisciplinary pain management, mechanisms of change, control beliefs, depression, pain interference, global perceived effect, pain catastrophizing
- MeSH terms
- Adaptation, Psychological, Adult, Cognition, Emotions, Female, Humans, Male, Middle Aged, Prospective Studies, Chronic Pain
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