This biobehavioral protocol enables measurement of chronic pain suffering and protection in three dimensions: physical, emotional, and cognitive.

No abstract

back pain, and were included if they completed pain-focused cognitive behavioral therapy (CBT) in addition to prescribed medical care. Patients completed the Functional Disability Inventory (FDI) and Numeric Rating Scale (NRS) of average pain intensity at initial evaluation and at subsequent psychology sessions as part of routine clinical care. Data regarding additional treatment modalities were extracted from the electronic medical record. Aside from CBT, patients most frequently received follow-up medical visits (94.7%), physical therapy (94.7%), medication management (100%), and a TENS unit (84.2%). Muscle relaxants (84.2%) and nonsteroidal anti-inflammatory drugs (73.3%) were most commonly prescribed. The average length of physical therapy and CBT was 10.7 sessions (range 4-27) and 6.2 sessions (range 3-11). Use of interventional strategies (injections) was infrequent (10.5%). Paired-sample t-tests showed significant reductions in both functional disability [t (19) =4.55, p<.001] and average pain intensity [t (19) =2.96, p<.01] following the conclusion of CBT in the context of multidisciplinary care. Post-treatment FDI scores decreased from 24.7 (SD=8.3) to 14.8 (SD=7.9); average pain intensity decreased from 5.8 (SD=1.6) to 4.0 (SD=2.2). The 10-point FDI decrease suggests clinically significant change 1 , and the post-treatment score was within 2-points of the minimal disability level suggesting improvement in the ability to engage in routine activities. Multidisciplinary treatment appears effective but is time intensive and can interrupt normative adolescent activities, which illuminates the need to develop better integrated treatment approaches. (Kashikar-Zuck S, Pain, 2011). (530) Distress intolerance and prescription opioid misuse among patients with chronic pain

No abstract