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Prolonged exposure for pain and comorbid PTSD: A single-case experimental study of a treatment supplement to multiprofessional pain rehabilitation

Åkerblom, Sophia LU ; Perrin, Sean LU orcid ; Rivano Fischer, Marcelo LU and McCracken, Lance (2022) In Scandinavian Journal of Pain 22(2).
Abstract
It is unclear how to address PTSD in the context of chronic pain management. Here we examine the potential benefits of an addition of prolonged exposure (PE) therapy for PTSD for adults attending multidisciplinary CBT for chronic pain. Four adults seeking treatment for chronic pain from a specialized pain rehabilitation service were offered PE for PTSD using a replicated, randomized, single-case experimental phase design, prior to commencing a 5-week multidisciplinary CBT program for chronic pain. Pre-, post-, follow-up, and daily measures allowed examination of PTSD and pain outcomes, potential mediators, and the trajectory of these outcomes and potential mediators during the subsequent pain-focused CBT program. Visual inspection of the... (More)
It is unclear how to address PTSD in the context of chronic pain management. Here we examine the potential benefits of an addition of prolonged exposure (PE) therapy for PTSD for adults attending multidisciplinary CBT for chronic pain. Four adults seeking treatment for chronic pain from a specialized pain rehabilitation service were offered PE for PTSD using a replicated, randomized, single-case experimental phase design, prior to commencing a 5-week multidisciplinary CBT program for chronic pain. Pre-, post-, follow-up, and daily measures allowed examination of PTSD and pain outcomes, potential mediators, and the trajectory of these outcomes and potential mediators during the subsequent pain-focused CBT program. Visual inspection of the daily data demonstrated changes in all outcome variables and potential mediators during the PE phase. Changes came at different times and at different rates for the four participants, highlighting the individual nature of putative change mechanisms. Consistent with expectation, PE produced reliable change in the severity of PTSD symptoms and trauma-related beliefs for all four participants, either by the end of the PE phase or the PE follow-up, with these gains maintained by the end of the 5-week pain-focused CBT program. However, few reductions in pain intensity or pain interference were seen either during the PE phase or after. Although "disorder specific"approaches have dominated the conceptualising, study, and treatment of conditions like PTSD and chronic pain, such approaches may not be optimal. It may be better instead to approach cases in an individual and process-focused fashion. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PTSD, Chronic Pain, Prolonged Exposure Therapy, Clinical Trial
in
Scandinavian Journal of Pain
volume
22
issue
2
publisher
Elsevier
external identifiers
  • scopus:85122622826
ISSN
1877-8860
language
English
LU publication?
yes
id
8ec733b9-cd1b-4556-8a12-f7c4b4c7af6f
date added to LUP
2021-11-29 19:44:22
date last changed
2023-02-22 10:56:28
@article{8ec733b9-cd1b-4556-8a12-f7c4b4c7af6f,
  abstract     = {{It is unclear how to address PTSD in the context of chronic pain management. Here we examine the potential benefits of an addition of prolonged exposure (PE) therapy for PTSD for adults attending multidisciplinary CBT for chronic pain. Four adults seeking treatment for chronic pain from a specialized pain rehabilitation service were offered PE for PTSD using a replicated, randomized, single-case experimental phase design, prior to commencing a 5-week multidisciplinary CBT program for chronic pain. Pre-, post-, follow-up, and daily measures allowed examination of PTSD and pain outcomes, potential mediators, and the trajectory of these outcomes and potential mediators during the subsequent pain-focused CBT program. Visual inspection of the daily data demonstrated changes in all outcome variables and potential mediators during the PE phase. Changes came at different times and at different rates for the four participants, highlighting the individual nature of putative change mechanisms. Consistent with expectation, PE produced reliable change in the severity of PTSD symptoms and trauma-related beliefs for all four participants, either by the end of the PE phase or the PE follow-up, with these gains maintained by the end of the 5-week pain-focused CBT program. However, few reductions in pain intensity or pain interference were seen either during the PE phase or after. Although "disorder specific"approaches have dominated the conceptualising, study, and treatment of conditions like PTSD and chronic pain, such approaches may not be optimal. It may be better instead to approach cases in an individual and process-focused fashion.}},
  author       = {{Åkerblom, Sophia and Perrin, Sean and Rivano Fischer, Marcelo and McCracken, Lance}},
  issn         = {{1877-8860}},
  keywords     = {{PTSD; Chronic Pain; Prolonged Exposure Therapy; Clinical Trial}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{2}},
  publisher    = {{Elsevier}},
  series       = {{Scandinavian Journal of Pain}},
  title        = {{Prolonged exposure for pain and comorbid PTSD: A single-case experimental study of a treatment supplement to multiprofessional pain rehabilitation}},
  volume       = {{22}},
  year         = {{2022}},
}