oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Both early and late changes in psychological variables relate to treatment outcome for musculoskeletal pain patients at risk for disability
Örebro University, School of Law, Psychology and Social Work. (Center for Health and Medical Psychology (CHAMP))
Örebro University, School of Law, Psychology and Social Work. (Center for Health and Medical Psychology (CHAMP))ORCID iD: 0000-0001-9429-9012
Örebro University, School of Law, Psychology and Social Work. (Center for Health and Medical Psychology (CHAMP))ORCID iD: 0000-0001-5359-0452
2013 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 50, no 11, p. 726-734Article in journal (Refereed) Published
Abstract [en]

We know little about why some people get better after psychological treatments for pain disability, whereas other people do not. In order to understand differences in treatment response, we need to explore processes of change during treatment. It has been suggested that people with pain complaints who change early in treatment have better outcomes. Therefore, we aimed to investigate whether changes in psychological variables at different time points are related to outcome, and whether early or late changes are better predictors of outcome. We used the fear avoidance model as a theoretical framework. We followed 64 patients weekly over 6–7 weeks and then determined outcome. Our findings indicate that people who decrease in catastrophizing and function early in treatment as well as in depressive symptoms, worry, fear avoidance beliefs and function late in treatment have better outcomes. Early decreases in function, and late decreases in depressive symptoms and worry uniquely predict improvements in disability. While early and late changes covaried concurrently, there were no significant sequential relationships between early and late changes. Changes in the proposed process variables in the fear avoidance model, early as well as late in treatment, thus add valuable information to the explanation of outcome.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 50, no 11, p. 726-734
Keywords [en]
Pain-related disability, Psychological treatment, CBT, Process of change, Treatment response
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-28927DOI: 10.1016/j.brat.2012.08.008ISI: 000311178800010PubMedID: 23000845Scopus ID: 2-s2.0-84866305805OAI: oai:DiVA.org:oru-28927DiVA, id: diva2:619470
Available from: 2013-05-03 Created: 2013-05-03 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Matchmaking in pain practice: challenges and possibilities
Open this publication in new window or tab >>Matchmaking in pain practice: challenges and possibilities
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

All people experience pain and for some people, acute pain may over time develop into long-term disabling problems. Already at an early stage, it is possible to identify people at risk for long-term problems and psychologically oriented interventions have been shown to successfully prevent future disability. However, not all people are helped by treatment and there is room for improvement. Moreover, subgroups of people suffering from pain, with different profiles of psychological factors have been identified, indicating that people with pain problems differ. The first aim of this dissertation was to improve the understanding of how people differ. The second aim was to use these individual differences and to match people to psychological treatment based on their psychological profile. The third aim was to explore what happens during treatment that might be important for treatment outcome.

The findings show that people who belonged to subgroups with elevated levels of psychological factors had less favorable outcomes over time, despite treatment, than people with no elevations. Moreover, people with elevations in several psychological factors had even less favorable outcomes. Psychological treatments aimed at preventing future disability performed well, but using profiles to match people to treatment did not improve outcomes further; people who were matched to a treatment and people who were unmatched had similar outcomes. However, the profiles used for matching were unstable over time and there is need to improve the identification of psychological variables used for treatment matching. Finally, a number of psychological factors were shown to be valuable targets for treatment; if the treatments successfully produced change in people’s thoughts and emotions related to pain the treatment outcomes were better. The findings were summarized in a flow chart showing the recommended clinical approach to people seekinghealth care for acute pain problems.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2014. p. 91
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 29
Keywords
pain, psychological profiles; psychological treatment; early intervention; secondary prevention; treatment matching
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-33751 (URN)978-91-7529-006-5 (ISBN)
Public defence
2014-03-28, Hörsal L3, Långhuset, Örebro universitet, Fakultetsgatan 1, Örebro, 10:15 (English)
Opponent
Supervisors
Available from: 2014-02-14 Created: 2014-02-14 Last updated: 2018-04-17Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Bergbom, SofiaBoersma, KatjaLinton, Steven J.

Search in DiVA

By author/editor
Bergbom, SofiaBoersma, KatjaLinton, Steven J.
By organisation
School of Law, Psychology and Social Work
In the same journal
Behaviour Research and Therapy
Psychology

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 404 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf