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AB0847-HPR Cognitive mechanisms of change in multidisciplinary treatment of patients with chronic wide spread pain: a prospective cohort study
  1. A. De Rooij1,
  2. M. R. de Boer2,
  3. M. van der Leeden1,
  4. L. D. Roorda1,
  5. M. P. Steultjens3,
  6. J. Dekker4
  1. 1Amsterdam Rehabilitation Research Center | Reade
  2. 2Department of Health Sciences, VU University, Amsterdam, Netherlands
  3. 3School of Health, Glasgow Caledonian University, Glasgow, United Kingdom
  4. 4Department of Rehabilitation Medicine, Psychiatry and EMGO Institute, VU University Medical Centre, Amsterdam, Netherlands


Background Cognitive mechanisms of change in the multidisciplinary treatment of patients with chronic widespread pain (CWP) are only partially understood.

Objectives To evaluate the contribution of improvement in negative emotional cognitions, active cognitive coping, and control and chronicity beliefs to the outcome of the multidisciplinary treatment in patients with chronic widespread pain (CWP).

Methods Data were used from baseline, 6 months and 18 months follow-up of a prospective cohort study of 120 CWP patients who completed a multidisciplinary pain management treatment. Longitudinal relationships were analyzed between changes in cognitions and outcome, using generalized estimated equations. Outcome domains included: pain, interference of pain in daily life, depression and global perceived effect.

Results Improvements in negative emotional cognitions were associated with improvements in all outcome domains, in particular with improvement in interference of pain in daily life and depression. Improvements in active cognitive coping were associated with improvements in interference of pain in daily life. Finally, improvements in control and chronicity beliefs were associated with improvements in pain and depression.

Conclusions Improvement in negative emotional cognitions seems to be a key mechanism of change of multidisciplinary treatment in CWP. Improvement of active cognitive coping and improvement of control and chronic timeline beliefs may constitute mechanisms of change as well, although the evidence is less strong.

Disclosure of Interest None Declared

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