Cognitive exposure versus avoidance in patients with chronic pain: Adherence matters

Abstract

The addition of IE to behavioural exposure did not improve outcomes. However, higher adherence to either attentional strategy was associated with larger effect sizes on all measures, suggesting factors shared by the two treatments could have contributed to the outcomes. Taken as a whole, the results suggest that increasing adherence to treatment strategies, possibly by motivational measures, would improve the overall outcomes of these interventions.

A 2-Item Short Form of the Pain Self-Efficacy Questionnaire: Development and Psychometric Evaluation of PSEQ-2

“…To evaluate test-retest reliability, sensitivity to change, and convergent validity, we used a separate sample (Sample 3, n = 140) that had recently completed an intervention designed, in part, to modify self-efficacy beliefs. 41 …”

“…The data employed in this study were derived from previous studies [39][40][41] at this center that had been approved by the Northern Sydney Area Human Ethics Committee. All participants provided written informed consent allowing us to use their deidentified data in this research.…”

“…Pain self-efficacy has been shown to be an important predictor of disability associated with pain 16 and is strongly associated with attrition 10 and functional changes after pain management programs, including capacity for work. 1,11,18,41,42,45,51 The Pain SelfEfficacy Questionnaire (PSEQ) 37,38 is a well-established and widely used measure of self-efficacy in people with chronic pain. 1,3,4,7,33,50 The questionnaire has been validated in a number of clinical populations and has been translated into several languages.…”

Psychological Interventions for the Management of Chronic Pain: a Review of Current Evidence

“…The interviews with these patients indicated that addressing loss and cultivating acceptance may be crucial before any behavior changes are initiated. Nicholas et al studied whether a behavioral exposure method that aims to reduce pain-avoidance behaviors would add benefit to standard CBT [15]. Although the results appeared to indicate that this add-on to CBT did not significantly differ from CBT alone, higher adherence in each group was once again associated with improvement on measures of pain, pain perception, disability, and depression.…”

Eficacia de un Tratamiento Cognitivo Comportamental (TCC) con apoyo de Tecnologías de la Información y la Comunicación (TICs) para el dolor lumbar crónico. Ensayo clínico aleatorizado

“…(2015) se estudió el efecto de la TCC en pacientes australianos con dolor crónico en un entorno de salud pública, a través de 5 sesiones online aplicadas a lo largo de 8 semanas, encontrándose grandes mejoras en variables como discapacidad, ansiedad, depresión y la media de dolor percibido tras el tratamiento, mejoras que fueron mantenidas en el seguimiento a los 3 meses. Además, se encontraron efectos de pequeños a moderados en otras variables de interés como la autoeficacia antes el dolor, el miedo al movimiento y la aceptación del dolor, que se han identificado como objetivos importantes en la TCC para el manejo del dolor (Nicholas et al, 2012;Nicholas et al, 2014). Por añadidura, los pacientes mostraron una elevada satisfacción con el tratamiento y una reducción del uso de medicación y de las demandas y el uso de los servicios de salud.…”