Relationship between pain anxiety and coping and response to a multidisciplinary treatment for chronic pain: A clinical evaluation
Browne A L1,2, Schug S A1,2, Ray P1
1Pain Medicine Centre, Royal Perth Hospital, Shenton Park, Western Australia.; 2School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia.
Purpose of Study
There is now considerable evidence supporting the efficacy of multidisciplinary cognitive behavioural interventions for the management of chronic pain. Yet, little research has investigated factors that determine treatment response. This study is based on a clinical evaluation that aimed to identify specific psychological 'process' variables (pain anxiety, coping responses) that could determine treatment outcomes (pain intensity and distress, pain disability and interference) among patients attending a three-week outpatient multidisciplinary intervention for chronic pain.
Method
Participants were 27 patients (Mean age = 41.07 years, 28.6% female, chronicity Mdn = 9 years) who received a group intervention founded on a cognitive behavioural approach to pain management. At pre and post test patients completed standardized outcome measures of pain intensity and distress, perceived disability and pain-related interference, and multidimensional measures of pain anxiety and coping.
Result
No significant changes from pre to post test in pain intensity or distress were found, however, there were significant declines in pain-related interference and disability (p < 0.01). Of the different types of pain anxiety and coping strategies assessed, a significant decline in catastrophizing coping responses (p < 0.01) and improvements approaching significance (bonferonni = 0.01) were observed in cognitive pain-related anxiety and behavioural coping responses (p < 0.05). Preliminary results suggest that changes in cognitive pain-related anxiety could be positively associated with changes in pain-related interference, after controlling for age, gender, and pain chronicity (p < 0.05). Improvements in perceived disability were not significantly associated with changes in pain anxiety or coping strategies.
Conclusion
Findings from this clinical evaluation provide preliminary evidence to suggest that short-term changes in pain anxiety could underlie declines in pain-related interference following an outpatient multidisciplinary chronic pain intervention. Furthermore, these results are consistent with a cognitive-behavioural pain management model where interactions between cognitive shifts and behavioural outcomes are expected.
Time of Presentation
Saturday 7 May 2005 - 1530-1700
