• Rona Moss-Morris, Katrina Humphrey, Malcolm H Johnson, and Keith J Petrie.
• School of Psychology, University of Southampton, Highfield, Southampton, United Kingdom. remm@soton.ac.uk
• Clin J Pain. 2007 Sep 1; 23 (7): 558-64.

ObjectivesThe primary aim of this study was to determine whether changes in cognitive processes are related to improved functional outcomes across a multidisciplinary pain management program.MethodsA longitudinal design was employed where patients completed 6 versions of the same questionnaire at the beginning, middle, and end of the 4-week treatment program and at 1, 3, and 6 months follow-up. Seventy-six patients consented to participate in this study. Outcome was assessed using the physical and mental component scores of the Short Form Health Questionnaire. Measures of cognitive processes included the Illness Perceptions Questionnaire Revised, the Pain Catastrophizing Scale, and the Pain Vigilance and Awareness Questionnaire. Fifty-eight patients (76%) completed all 6 questionnaires.ResultsWe found reductions in catastrophizing and beliefs about the serious consequences of pain were most strongly associated with improved physical functioning, whereas reductions in pain vigilance, emotional representations of pain, and sense of coherence about pain were the best predictors of improved mental functioning. Overall, change in cognitive processes accounted for 26% of the variance in improved physical functioning and 23% of the variance in mental functioning.DiscussionThese findings suggest that interventions that specifically target cognitive processes may enhance treatment effects for patients with chronic pain.

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