title: Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? A cross-lagged panel analysis.
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 catastrophizing, pain helplessness, depression, pain, interference, and activity level at pre-, mid-, and posttreatment. With depression changes controlled, early-treatment catastrophizing and pain helplessness changes predicted late-treatment outcome index changes, but not vice versa; early-treatment depression changes predicted late-treatment activity changes, but not vice versa. Findings advance understanding of pain treatment process and suggest that negative cognition changes may indeed affect improvements in treatment outcome.
authors.affiliation: Department of Psychology, Finch University of Health Sciences/Chicago Medical School, Illinois 60064, USA. burnsj@finchcms.edu
authors.forename: John W
authors.initials: JW
authors.lastname: Burns
authors.forename: Amanda
authors.initials: A
authors.lastname: Kubilus
authors.forename: Stephen
authors.initials: S
authors.lastname: Bruehl
authors.forename: R Norman
authors.initials: RN
authors.lastname: Harden
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lofland
mesh_terms: D000223:Adaptation, Psychological; D002908:Chronic Disease; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis; D059408:Pain Management; D010147:Pain Measurement; D010348:Patient Care Team; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome