Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo

Although cognitive-behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chr...

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Main Authors: Johan WS Vlaeyen, Jeroen R de Jong, Patrick Onghena, Maria Kerckhoffs-Hanssen, Ank MJ Kole-Snijders
Format: Article
Language:English
Published: Wiley 2002-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2002/493463
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author Johan WS Vlaeyen
Jeroen R de Jong
Patrick Onghena
Maria Kerckhoffs-Hanssen
Ank MJ Kole-Snijders
author_facet Johan WS Vlaeyen
Jeroen R de Jong
Patrick Onghena
Maria Kerckhoffs-Hanssen
Ank MJ Kole-Snijders
author_sort Johan WS Vlaeyen
collection DOAJ
description Although cognitive-behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chronic pain disability. Evidence is accumulating in support of the conjecture that pain-related fear and associated avoidance behaviours are crucial in the development and maintenance of chronic pain disability. It seems timely to apply this knowledge to the cognitive-behavioural management of chronic pain. Two studies are presented here. Study 1 concerns a secondary analysis of data gathered in a clinical trial that was aimed at the examination of the supplementary value of coping skills training when added to an operant-behavioural treatment in patients with chronic back pain. The results show that, compared with a waiting list control, an operant-behavioural treatment with or without pain-coping skills training produced very modest and clinically negligible decreases in pain-related fear. Study 2 presents the effects of more systematic exposure in vivo treatment with behavioural experiments in two single patients reporting substantial pain-related fear. Randomization tests for AB designs revealed dramatic changes in pain-related fear and pain catastrophizing. In both cases, pain intensity also decreased significantly, but at a slower pace. Differences before and after treatment revealed clinically significant improvements in pain vigilance and pain disability.
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spelling doaj-art-3d0440da14fb4fd0a04a00dc41174e752025-08-20T02:39:11ZengWileyPain Research and Management1203-67652002-01-017314415310.1155/2002/493463Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in VivoJohan WS Vlaeyen0Jeroen R de Jong1Patrick Onghena2Maria Kerckhoffs-Hanssen3Ank MJ Kole-Snijders4Department of Medical, Clinical and Experimental Psychology, Maastricht University, PO Box 616, 6200 MD Maastricht, The NetherlandsDepartment of Medical Psychology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The NetherlandsDepartment of Educational Sciences, Katholieke Universiteit Leuven, Vesaliusstraat 2, 3000 Leuven, BelgiumDepartment of Physical Therapy, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The NetherlandsRehabilitation Center "Hoensbroeck", PO Box 88, 6430 AB Hoensbroek, The NetherlandsAlthough cognitive-behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chronic pain disability. Evidence is accumulating in support of the conjecture that pain-related fear and associated avoidance behaviours are crucial in the development and maintenance of chronic pain disability. It seems timely to apply this knowledge to the cognitive-behavioural management of chronic pain. Two studies are presented here. Study 1 concerns a secondary analysis of data gathered in a clinical trial that was aimed at the examination of the supplementary value of coping skills training when added to an operant-behavioural treatment in patients with chronic back pain. The results show that, compared with a waiting list control, an operant-behavioural treatment with or without pain-coping skills training produced very modest and clinically negligible decreases in pain-related fear. Study 2 presents the effects of more systematic exposure in vivo treatment with behavioural experiments in two single patients reporting substantial pain-related fear. Randomization tests for AB designs revealed dramatic changes in pain-related fear and pain catastrophizing. In both cases, pain intensity also decreased significantly, but at a slower pace. Differences before and after treatment revealed clinically significant improvements in pain vigilance and pain disability.http://dx.doi.org/10.1155/2002/493463
spellingShingle Johan WS Vlaeyen
Jeroen R de Jong
Patrick Onghena
Maria Kerckhoffs-Hanssen
Ank MJ Kole-Snijders
Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo
Pain Research and Management
title Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo
title_full Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo
title_fullStr Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo
title_full_unstemmed Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo
title_short Can Pain-Related Fear Be Reduced? The Application of Cognitive-Behavioural Exposure in Vivo
title_sort can pain related fear be reduced the application of cognitive behavioural exposure in vivo
url http://dx.doi.org/10.1155/2002/493463
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