title: Happy Despite Pain: A Randomized Controlled Trial of an 8-Week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients With Chronic Pain.
abstract: OBJECTIVE
  There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program.
  
  
  METHODS
  A randomized controlled trial was carried out with 3 conditions: an internet-delivered positive psychology program, an internet-delivered cognitive-behavioral program and waitlist control. A total of 276 patients were randomized to 1 of the 3 conditions and posttreatment data were obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at posttreatment and at 6-month follow-up. Intention-to-treat analyses were carried out using mixed regression analyses.
  
  
  RESULTS
  Both treatments led to significant increases in happiness and decreases in depression. Physical impairments did not significantly decrease compared with waitlist. Improvements in happiness and depression were maintained until 6-month follow-up. There were no overall differences in the efficacy of the 2 active interventions but effects seemed to be moderated by education. Patients with a higher level of education profited slightly more from the positive psychology intervention than from the cognitive-behavioral program.
  
  
  CONCLUSIONS
  The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.
authors.affiliation: *Department of Clinical Psychological Science †MEMIC ‡Department of Methodology and Statistics, and CAPHRI School for Care and Public Health, Maastricht University, The Netherlands §Department of Behavioural Sciences and Learning, Linköping University, Linköping ∥Department of Clinical Neuroscience, Karolinska Institute, Stockholm ¶Department of Psychology, Uppsala University, Uppsala #Center for Health and Medical Psychology, Örebro University, Sweden.
authors.forename: Madelon L
authors.initials: ML
authors.lastname: Peters
authors.forename: Elke
authors.initials: E
authors.lastname: Smeets
authors.forename: Marion
authors.initials: M
authors.lastname: Feijge
authors.forename: Gerard
authors.initials: G
authors.lastname: van Breukelen
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.forename: Monica
authors.initials: M
authors.lastname: Buhrman
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Linton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D003863:Depression; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006240:Happiness; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D010352:Patient Dropouts; D011613:Psychotherapy / Q000379:methods; D012044:Regression Analysis; D017216:Telemedicine; D016896:Treatment Outcome; D055815:Young Adult