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J Psychosom Res. 2016 Feb;81:1-8. doi: 10.1016/j.jpsychores.2015.12.003. Epub 2015 Dec 11.

The effects of a novel psychological attribution and emotional awareness and expression therapy for chronic musculoskeletal pain: A preliminary, uncontrolled trial.

Author information

1
Department of Psychology, Wayne State University, Detroit, MI, USA.
2
Department of Psychology, Wayne State University, Detroit, MI, USA. Electronic address: mlumley@wayne.edu.
3
Department of Internal Medicine, St. John/Providence Health System, Southfield, MI, USA.

Abstract

OBJECTIVE:

Current psychological and behavioral therapies for chronic musculoskeletal pain only modestly reduce pain, disability, and distress. These limited effects may be due to the failure of current therapies: a) to help patients learn that their pain is influenced primarily by central nervous system psychological processes; and b) to enhance awareness and expression of emotions related to psychological trauma or conflict.

METHODS:

We developed and conducted a preliminary, uncontrolled test of a novel psychological attribution and emotional awareness and expression therapy that involves an initial individual consultation followed by 4 group sessions. A series of 72 patients with chronic musculoskeletal pain had the intervention and were assessed at baseline, post-treatment, and 6-month follow-up.

RESULTS:

Participation and satisfaction were high and attrition was low. Intent-to-treat analyses found significant improvements in hypothesized change processes: psychological attributions for pain, emotional awareness, emotional approach coping, and alexithymia. Pain, interference, depression, and distress showed large effect size improvements at post-treatment, which were maintained or even enhanced at 6 months. Approximately two-thirds of the patients improved at least 30% in pain and other outcomes, and one-third of the patients improved 70%. Changes in attribution and emotional processes predicted outcomes. Higher baseline depressive symptoms predicted greater improvements, and outcomes were comparable for patients with widespread vs. localized pain.

CONCLUSION:

This novel intervention may lead to greater benefits than available psychological interventions for patients with chronic musculoskeletal pain, but needs controlled testing.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00861302.

KEYWORDS:

Attribution; Chronic pain; Clinical trial; Emotional awareness; Emotional expression; Registered at Clinicaltrials.gov (NCT00861302)

PMID:
26800632
PMCID:
PMC4724386
DOI:
10.1016/j.jpsychores.2015.12.003
[Indexed for MEDLINE]
Free PMC Article

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