title: The pain provocation technique for adolescents with chronic pain: preliminary evidence for its effectiveness.
abstract: OBJECTIVE
  This study aims to investigate the effectiveness of the "pain provocation technique" (PPT)--a focused treatment strategy incorporating interoceptive exposure (i.e., imagining increases in pain intensity), bilateral stimulation (tactile stimulation), and implementation of pain-related coping to decrease pain intensity--for adolescents suffering from chronic pain.
  
  
  METHODS
  Prospective observational comparative study.
  
  
  METHODS
  Adolescents utilizing PPT (19 boys and 21 girls) within multimodal inpatient treatment were compared with adolescents in standard multimodal inpatient treatment matched for age, gender, and diagnosis. Core outcome variables (pain intensity, disability, emotional distress) were assessed at admission and 3 months posttreatment.
  
  
  RESULTS
  Adolescents in the PPT group demonstrated a sharper decrease in pain intensity and school aversion. Both groups demonstrated significant reductions in disability and emotional distress.
  
  
  CONCLUSIONS
  Results are discussed in terms of the importance of focused treatment strategies such as interoceptive exposure for adolescents suffering from disabling chronic pain. Future studies are warranted to carefully investigate the effectiveness and possible process of change during the PPT such as sensory, cognitive, emotional, and memory aspects.
authors.affiliation: Vodafone Foundation Institute and Children's Pain Therapy and Paediatric Palliative Care, Children's and Adolescents' Hospital, Datteln, Witten/Herdecke University, Datteln, Germany. jon.raphael@bcu.ac.uk
authors.forename: Tanja
authors.initials: T
authors.lastname: Hechler
authors.forename: Michael
authors.initials: M
authors.lastname: Dobe
authors.forename: Uta
authors.initials: U
authors.lastname: Damschen
authors.forename: Markus
authors.initials: M
authors.lastname: Blankenburg
authors.forename: Sandra
authors.initials: S
authors.lastname: Schroeder
authors.forename: Joachim
authors.initials: J
authors.lastname: Kosfelder
authors.forename: Boris
authors.initials: B
authors.lastname: Zernikow
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D001007:Anxiety; D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome