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Catastrophizing moderates the effect of exposure in vivo for back pain patients with pain-related fear
Örebro universitet, Akademin för juridik, psykologi och socialt arbete. (Center for Health and Medical Psychology (CHAMP))ORCID-id: 0000-0003-2718-7402
Örebro universitet, Akademin för juridik, psykologi och socialt arbete.ORCID-id: 0000-0001-9429-9012
Örebro universitet, Akademin för juridik, psykologi och socialt arbete.ORCID-id: 0000-0001-5359-0452
2010 (Engelska)Ingår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 14, nr 8, s. 887-892Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

This investigation was an initial attempt to explore psychological factors that might help or hinder the effect of exposure in vivo for patients with musculoskeletal pain and pain-related fear. The study was based on data from a randomized-controlled trial for patients with non-specific spinal pain (Linton et al., 2008).

First, catastrophizing, anxiety, and depression were studied as possible treatment moderators. We found evidence that catastrophizing was a moderator of treatment outcome in exposure. When further exploring the nature of the relationship between catastrophizing and outcome, the results showed that the exposure was effective only for patients with low or moderate levels of catastrophizing. High catastrophizers did not improve from the treatment. On the other hand, anxiety was a general predictor of poor outcome, and not a specific moderator of outcome in exposure. In contrast, depression was not significantly related to outcome.

Next, patients were divided into high change participants and low change participants based on their improvement in disability after treatment in order to investigate the change in psychological variables during treatment. Descriptive data indicated that high change participants had large improvements across treatment on depression, anxiety, catastrophizing, and fear-avoidance beliefs whereas low change participants virtually did not change at all on these variables across treatment.

These findings denote that catastrophizing is a moderator of treatment outcome in exposure whereas several psychological variables might be important for the treatment process

Ort, förlag, år, upplaga, sidor
2010. Vol. 14, nr 8, s. 887-892
Nationell ämneskategori
Psykologi
Forskningsämne
Psykologi
Identifikatorer
URN: urn:nbn:se:oru:diva-13430DOI: 10.1016/j.ejpain.2010.02.003ISI: 000281141400017OAI: oai:DiVA.org:oru-13430DiVA, id: diva2:385446
Tillgänglig från: 2011-01-11 Skapad: 2011-01-11 Senast uppdaterad: 2018-02-23Bibliografiskt granskad
Ingår i avhandling
1. Stuck in mind: the role of catastrophizing in pain
Öppna denna publikation i ny flik eller fönster >>Stuck in mind: the role of catastrophizing in pain
2011 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Pain catastrophizing emerges in the literature as one of the most important psychological determinants of both pain itself and the negative outcomes commonly associated with it. However, despite decades of research confirming the impact of catastrophizing, there are still areas that remain unexplored or in which the surface has only been scratched. The overall aim of this dissertation was to expand existing knowledge about catastrophizing and to advance the theoretical framework around the concept.

The role of catastrophizing was explored in three distinct areas: during pain in childbirth, in exposure treatment for back pain patients, and in a problem solving context. The findings from the three studies confirmed the vital role of catastrophizing in these areas. Firstly, catastrophizing played a critical role in pain in childbirth; women who catastrophized reported labor pain as more intense and the subsequent recovery period as longer than women who did not catastrophize. Secondly, catastrophizing was identified as a moderator of treatment effect in exposure in vivo for back pain patients with pain-related fear; patients who catastrophized were not helped by the exposure. Thirdly, catastrophizing played a role in a problem solving context; although this is in line with contemporary models such as the misdirected problem solving model, the results suggested a somewhat different pathway to this previous model. Taken together, these findings underscore the instrumental role of catastrophizing in diverse areas and imply a need for catastrophzing to be assessed and addressed in clinical contexts. In addition, the findings highlight a need for further development of the theoretical framework around catastrophizing as well as treatment interventions that directly target catastrophizing. Based on these needs, a new model of catastrophizing was proposed – a model of catastrophizing from a process perspective. In this model, the proposed function of catastrophizing is to down-regulate negative affect, as a form of internal avoidance. The model is a complement to existing theoretical models and provides a framework for developing treatment interventions that directly target catastrophizing, for example by problem solving skills training. Successful interventions for people who catastrophize would lead to several gains – for the individual in less suffering and increased ability to handle pain problems, and for society as a whole in reduced costs for health care for these individuals.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro universitet, 2011. s. 71
Serie
Örebro Studies in Psychology, ISSN 1651-1328 ; 21
Nyckelord
catastrophizing, pain, fear avoidance, problem solving
Nationell ämneskategori
Samhällsvetenskap Psykologi
Forskningsämne
Psykologi
Identifikatorer
urn:nbn:se:oru:diva-19125 (URN)978-91-7668-826-7 (ISBN)
Disputation
2011-12-02, Hörsal L2, Örebro universitet, Fakultetsgatan 1, Örebro, 13:15
Opponent
Handledare
Tillgänglig från: 2011-10-04 Skapad: 2011-10-04 Senast uppdaterad: 2017-10-17Bibliografiskt granskad

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Flink, Ida K.Boersma, KatjaLinton, Steven J.

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