A randomized clinical trial of targeted cognitive behavioral treatment to reduce catastrophizing in chronic headache sufferers
A randomized clinical trial of targeted cognitive behavioral treatment to reduce catastrophizing in chronic headache sufferers
复制标题
DOI：
10.1016/j.jpain.2007.06.010
复制
发表时间：
2007-12-01
期刊：
影响因子：
4
通讯作者：
Tsui, Patricia W.
中科院分区：
文献类型：
--
作者：
Thorn, Beverly E.;Pence, Laura B.;Tsui, Patricia W.
这项随机临床试验 (RCT) 检查了专门针对减轻慢性头痛患者灾难性疼痛的认知行为治疗 (CBT) 的功效。将立即治疗组与等待名单对照组进行比较。研究了基于 CBT 两个组成部分（认知重建和认知/行为应对）的呈现顺序的差异化治疗收益以及灾难化在治疗结果中的作用。 34 名参与者参加了为期 10 周的团体治疗，其中 11 名参与者完成了等待名单上的自我监测期。与等待名单上的对照组受试者相比，参与者报告说，他们的灾难性和焦虑感显着减少，自我效能感提高，并且这些在随访中得到维持。尽管我们没有发现与候补名单对照受试者相比，头痛频率或强度减少方面存在总体差异，但对头痛指标临床意义的计算表明，约 50% 的接受治疗的受试者也表现出头痛指数的有意义的变化。治疗模块的顺序与治疗期间或随访期间的收益无关；然而，几乎所有变化都发生在治疗的后半段，这表明治疗参与的持续时间很重要。 观点：以减少慢性头痛灾难化为目标的认知行为治疗减少了与复发性头痛相关的负面认知和情感变量，提高了头痛管理自我效能，并且一半的参与者产生了具有临床意义的头痛指标减少。治疗慢性疼痛时，治疗时间是一个需要考虑的重要因素。 (c) 2007 年，美国疼痛协会。
This randomized clinical trial (RCT) examined the efficacy of a cognitive-behavioral treatment (CBT) specifically targeted toward reducing pain catastrophizing for persons with chronic headache. Immediate treatment groups were compared with wait-list control groups. Differential treatment gains based on the order of presentation of 2 components of CBT (cognitive restructuring and cognitive/behavioral coping) and the role of catastrophizing in treatment outcome were examined. Thirty-four participants enrolled in a 10-week group treatment and 11 completed a wait-list self-monitoring period. Participants reported significant reductions in catastrophizing and anxiety and increased self-efficacy compared with wait-list control subjects, and these were maintained at follow-up. Although we did not find overall differences in the reduction of headache frequency or intensity compared with wait-list control subjects, calculation of clinical significance on headache indicators suggest that approximately 50% of treated participants showed meaningful changes in headache indices as well. Order of treatment modules was not related to gains during treatment or at follow-up; however, almost all changes occurred during the second half of treatment, suggesting that duration of treatment participation is important.Perspective: Cognitive-behavioral treatment targeting reduction of catastrophizing for chronic headache pain reduced negative cognitive and affective variables associated with recurrent headache, increased headache management self-efficacy, and in half of the participants, produced clinically meaningful reductions in headache indicators. Length of treatment is an important factor to consider when providing CBT for chronic pain. (c) 2007 by the American Pain Society.