Do Changes in Cognitions Influence Outcome in the Treatment of Chronic Pain?

Burns, J. W., Kubilus, A., Bruhel, S., Harden, N. & Lofland, K. (2003). Do Changes in Cognitive Factors Influence Outcome Following Multidisciplinary Treatment for Chronic Pain? A Cross-Lagged Panel Analysis, Journal of Consulting and Clinical Psychology, 71, 81-91.

ABSTRACT - Changes in maladaptive cognitions may constitute therapeutic processes of multidisciplinary pain programs. A cross-lagged panel design was used to determine whether (a) early-treatment cognitive change predicted late-treatment outcome index change, but not vice versa; and (b) these effects remained significant with depression change controlled. Ninety chronic pain patients, in a 4-week multidisciplinary program, completed measures of catastrophisizing, pain helplessness, depression, pain, interference, and activity level at pre-, mid-, and post-treatment. With depression changes controlled, early treatment catastrophizing and pain helplessness predicted late treatment outcome index changes, but not vice versa; early-treatment depression changes predicted late treatment activity changes, but not vice versa. Findings advanced understanding of pain treatment process and suggest that negative cognition changes may indeed affect improvements in treatment outcome.

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