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Efficacy of a trans...
Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression : a randomized controlled trial
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- Boersma, Katja, professor, 1973- (author)
- Örebro universitet,Institutionen för juridik, psykologi och socialt arbete,Center for Health and Medical Psychology,Orebro Univ, Sweden
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- Södermark, Martin (author)
- Linköpings universitet,Avdelningen för samhällsmedicin,Medicinska fakulteten
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- Hesser, Hugo, 1982- (author)
- Linköpings universitet,Psykologi,Filosofiska fakulteten,Region Östergötland, Öron- näsa- och halskliniken
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- Flink, Ida, 1980- (author)
- Örebro universitet,Institutionen för juridik, psykologi och socialt arbete,Center for Health and Medical Psychology,Orebro Univ, Sweden
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- Gerdle, Björn, 1953- (author)
- Linköpings universitet,Avdelningen för samhällsmedicin,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum
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- Linton, Steven J., 1952- (author)
- Örebro universitet,Institutionen för juridik, psykologi och socialt arbete,Center for Health and Medical Psychology,Orebro Univ, Sweden
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(creator_code:org_t)
- 2019-04-06
- 2019
- English.
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In: Pain. - : Lippincott Williams & Wilkins. - 0304-3959 .- 1872-6623. ; 160:8, s. 1708-1718
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Abstract
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- The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8 treatment modules) addresses topics such as pain education, coping strategies, relaxation, problem solving, stress, and sleep management using standard CBT techniques. Patient-reported outcomes were assessed before and after treatment as well as at a 9-month primary end point. Across conditions, 78% participants completed post-treatment and 81% follow-up assessment. Intent-to-treat analyses showed that the hybrid had a significantly better post-treatment outcome on pain catastrophizing (d = 0.39) and pain interference (d = 0.63) and significantly better follow-up outcomes on depression (d = 0.43) and pain interference (d = 0.51). There were no differences on anxiety and pain intensity. Observed proportions of clinically significant improvement favoured the hybrid on all but one comparison, but no statistically significant differences were observed. We conclude that the hybrid emotion-focused treatment may be considered an acceptable, credible, and efficacious treatment option for chronic pain patients with comorbid emotional problems.
Subject headings
- SAMHÄLLSVETENSKAP -- Psykologi -- Tillämpad psykologi (hsv//swe)
- SOCIAL SCIENCES -- Psychology -- Applied Psychology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Keyword
- Chronic pain
- Emotional problems
- Transdiagnostic
- Cognitive-behavioral therapy
- Internet
- Randomized clinical trial
- Exposure
Publication and Content Type
- ref (subject category)
- art (subject category)
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Boersma, Katja, ...
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Södermark, Marti ...
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Hesser, Hugo, 19 ...
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Flink, Ida, 1980 ...
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Gerdle, Björn, 1 ...
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Linton, Steven J ...
- About the subject
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- SOCIAL SCIENCES
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SOCIAL SCIENCES
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and Psychology
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and Applied Psycholo ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and General Practice
- Articles in the publication
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Pain
- By the university
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Örebro University
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Linköping University