TAILORING COGNITIVE BEHAVIORAL TREATMENT FOR CANCER PAIN

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DESCRIPTION (Adapted from the Investigator's Abstract): The purpose of the proposed research is to evaluate the immediate and mid-range effectiveness of cognitive-behavioral treatment (CBT) for cancer pain matched to a diagnostic profile, derived from the Biobehavioral Pain Profile (BPP). A three-group experimental, repeated measures design will compare profile-tailored CBT patients with standard CBT and usual pain-treatment control group patients. Three hundred patients in four sites will be randomly assigned to study arm. CBT treatment will include cognitive-behavioral interventions such as education, guided-imagery, time-contingent interactions, attention-diversion, cognitive restructuring, and relaxation. It is hypothesized that at the end of treatment, patients who receive a CBT protocol matched to their BPP will report less pain intensity, fewer pain behaviors, greater responsiveness to treatment, greater durability of response, less interference of pain with activities, less symptom distress, better mood, functioning, sleep and quality of life, and greater achievement of personal goals than patients who receive standard CBT or usual pain treatment, and that the effect of the profile-tailored treatment will be sustained over time. Patients will be treated weekly for five weeks with assessment at baseline, end of the five weeks, 1- and 6-months post treatment using the Brief Pain Inventory, Symptom Distress Scale, Profile of Mood States, Katz ADL, SF-36, pain history and demographic sheets, and identification of goals and their achievement. Multivariate ANOVA will be used to compare the pre-intervention equivalence of the study groups and multivariate GLM analysis of repeated measures to test the primary hypothesis.