Which Pain Coping Strategies and Cognitions Are Associated with Outcomes of a Cognitive Behavioral Intervention for Neuropathic Pain after Spinal Cord Injury?

Top Spinal Cord Inj Rehabil, 2013 · DOI: 10.1310/sci1904-330 · Published: January 1, 2013

Spinal Cord Injury Mental Health Pain Management

Simple Explanation

This study investigates how pain coping strategies and beliefs relate to the success of cognitive behavioral therapy (CBT) for neuropathic pain after spinal cord injury (SCI). The research looked at how these strategies and beliefs changed during CBT and whether those changes were linked to improvements in pain intensity and how pain affected daily life. The findings suggest that CBT can positively influence pain coping and beliefs, potentially leading to reduced pain and improved daily functioning for individuals with SCI.

Study Duration

3 months

Participants

47 persons with spinal cord injury and chronic neuropathic pain

Evidence Level

RCT data analysis

Key Findings

1
Participants showed more favorable scores on pain coping scales (Pain Transformation and Worrying) and pain cognition scales (Catastrophizing, Optimism, and Reliance on Health Care) after the CBT intervention.
2
Baseline reliance on health care was associated with change in pain intensity and pain-related disability.
3
Changes in catastrophizing and restriction cognitions were associated with changes in pain-related disability.

Research Summary

This study explored the associations between pain coping strategies and cognitions on the one hand and pain intensity and pain-related disability on the other hand, all measured in the context of a multidisciplinary CBT program for CNSCIP. We found baseline pain coping strategies and pain cognitions to be associated with baseline pain intensity and pain-related disability. Our results suggest that pain coping strategies and cognitions may change during a brief CBT intervention, which could have some beneficial effect on pain intensity and pain-related disability in persons with CNSCIP.

Practical Implications

CBT Effectiveness

CBT of relatively limited intensity and duration might be useful to change pain cognitions and coping responses in persons with CNSCIP.

Predicting CBT Success

Reliance on health care was associated with a decrease in pain intensity and pain-related disability, suggesting that this pain cognition might predict the effectiveness of CBT for CNSCIP.

Targeted CBT

CBT programs should aim at decreasing the cognitions of catastrophizing, restrictions, and reliance on health care and decreasing passive coping to maximize the effectiveness of this type of intervention.

Study Limitations

1
Small sample size limited the statistical power and the use of multivariate analyses.
2
The analyses were conducted without a control group, so do not permit causal inference.
3
The self-report nature of the neuropathic pain, completeness, and level of injury variables.

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