title: A comparison of conventional pain coping skills training and pain coping skills training with a maintenance training component: a daily diary analysis of short- and long-term treatment effects.
abstract: Pain coping skills training (PCST) has been shown to produce immediate improvements in pain and disability in rheumatoid arthritis (RA). However, some patients have difficulty maintaining these gains. This study compared a conventional PCST protocol with a PCST protocol that included maintenance training (PCST/MT). Patients with RA (n = 167) were randomly assigned to either conventional PCST, PCST/MT, arthritis education control, or standard care control. Daily data were collected on joint pain, coping, coping efficacy, and mood. Multilevel analyses showed that at posttreatment, conventional PCST was superior to all other conditions in joint pain, coping efficacy, and negative mood, whereas PCST/MT was superior to all other conditions in emotion-focused coping and positive mood. At 18 months follow-up, both PCST conditions were superior to standard care in joint pain and coping efficacy. Interpretation of follow-up outcomes was limited by higher dropout rates in the 2 PCST groups. For RA, a maintenance training component does not appear to produce significant improvements over conventional PCST.
  
  
  CONCLUSIONS
  This article reports a trial evaluating a conventional pain coping skills training protocol and a similar protocol that included a maintenance training component. Overall, results indicate similar results for both the conventional and the modified protocols.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27708, USA. jim.cason@duke.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Carson
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: Glenn
authors.initials: G
authors.lastname: Affleck
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Rumble
authors.forename: David S
authors.initials: DS
authors.lastname: Caldwell
authors.forename: Pat M
authors.initials: PM
authors.lastname: Beaupre
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
authors.forename: Marlene
authors.initials: M
authors.lastname: Sandstrom
authors.forename: James N
authors.initials: JN
authors.lastname: Weisberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D059408:Pain Management; D013663:Teaching / Q000379:methods*; D013995:Time; D016896:Treatment Outcome