Cognitive and physical capacity process variables predict long-term outcome after treatment of chronic pain.

Abstract

The authors investigated whether attributions for positive life events predict decreases in hopelessness and depressive symptoms among clinically depressed adults. Measures of attributional style, attributions for recent events, depressive symptoms, dysfunctional attitudes, hopelessness, and life events were administered to 52 depressed psychiatric inpatients treated with antidepressant medication; the measures were readministered 12 and 24 days later. Results indicated that (a) internal, stable, global attributions for recent positive events mediated a significant association between attributional style for positive life events and decreased hopelessness; (b) decreases in hopelessness mediated a significant association between internal, stable, global attributions for recent positive events and decreases in depressive symptom levels; and (c) depressotypic cognitions were not associated with decreases in either hopelessness or depressive symptom levels.

The Mediating Role of Acceptance in Multidisciplinary Cognitive-Behavioral Therapy for Chronic Pain

“…Greater efforts are needed to identify "process variables" or mediators that could be used to refine CBT and improve outcomes. 56,50,54 A large number of psychological variables have been identified as potential CBT process variables, including pain beliefs and perceived control over pain, 19,20,50 social support, 42,43 coping, 19,20 self-efficacy, 50 helplessness, [4][5][6] affective distress, and catastrophizing. 4,6,45,46,50,52 CBT-based treatments have typically taken a broad focus on processes for change and incorporated diverse packages of methods.…”

Changes after multidisciplinary pain treatment in patient pain beliefs and coping are associated with concurrent changes in patient functioning

“…Consistent with cognitive-behavioral models of chronic pain, patients who receive multidisciplinary pain treatment demonstrate pre-to post-treatment as well as pretreatment to follow-up changes in pain beliefs and coping that are associated with changes in pain and functioning (Tota-Faucette et al, 1993;Jensen et al, 1994a;Turner et al, 1995;Burns et al, 1998;). This research has been useful for identifying beliefs and coping strategies that are most strongly and consistently associated with treatment outcome, and that therefore could be potential mechanisms of treatment efficacy.…”

Chronic pain and comorbid depression

“…The Beck Depression Inventory-II [23, Class II] is a widely accepted Depression may result in perpetuation of pain, increasing the number and severity of physical symptoms, and enhancing subjective assessments of pain-related disability [25,26 Class II]. Reduction of depression may reduce the predisposition of patients to augment pain severity ratings and perceived disability and is an important adjunct to rehabilitation efforts.…”