{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:56:46Z","timestamp":1788386206810,"version":"build-2803163510"},"reference-count":57,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Current therapeutic approaches are inaccessible to many people with chronic pain and frequently fail to address emotion dysregulation as a key factor in psychological comorbidity and pain intensity. An effective and accessible emotion regulation\u2013focused intervention is needed.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To compare the efficacy of online dialectical behavioral therapy for chronic pain plus treatment as usual (iDBT-Pain) with only treatment as usual on emotion dysregulation in people with chronic pain.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This 2-arm randomized clinical trial was conducted from March 2023 to September 2024 in Australia. Participants were adults with chronic pain (lasting \u22653 months) and weekly pain intensity of 3 or higher out of 10 (10 indicating worst pain), without psychotic or personality disorders, and without dementia. Eligible participants were randomly assigned (1:1 ratio) to receive either iDBT-Pain for 9 weeks or treatment as usual only. Intention-to-treat data analyses were performed between August and September 2024.<\/jats:p><\/jats:sec>Interventions<\/jats:title>The iDBT-Pain group received 8 group-based 90-minute therapist-guided online sessions as well as an app and a handbook for self-learning. Content focused on DBT skills training, including pain science education. Participants in the treatment-as-usual group continued usual care, which consisted of treatment options that can be accessed in the community.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was emotion dysregulation at 9 weeks after randomization. The Difficulties in Emotion Regulation Scale (score range: 18-90, with higher scores indicating higher emotion dysregulation) was used in assessment.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 89 participants (mean [SD] age, 51.5 [14.2] years; 74 females [83%]), 44 (49%) were randomly assigned to the treatment-as-usual group and 45 (51%) were randomly assigned to the iDBT-Pain group. Overall, 79 participants (89%) completed the 9-week assessment. Between-group difference in emotion dysregulation over time favored iDBT-Pain over treatment as usual at 9 weeks (\u22124.88; 95% CI, \u22129.20 to \u22120.55; P<\/jats:italic>\u2009=\u2009.03; Cohen d<\/jats:italic>\u2009=\u2009\u22120.46 [95% CI, \u22120.87 to \u22120.08]).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial, the iDBT-Pain intervention, delivered through a self-learning and therapist-guided hybrid approach, resulted in sustained improvements in emotion dysregulation in people with chronic pain.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>Anzctr.org.au Identifier: ACTRN12622000113752<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.6908","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T15:00:27Z","timestamp":1746543627000},"page":"e256908","source":"Crossref","is-referenced-by-count":17,"title":["Online Dialectical Behavioral Therapy for Emotion Dysregulation in People With Chronic Pain"],"prefix":"10.1001","volume":"8","author":[{"given":"Nell","family":"Norman-Nott","sequence":"first","affiliation":[{"name":"NeuroRecovery Research Hub, School of Psychology, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy E.","family":"Briggs","sequence":"additional","affiliation":[{"name":"Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negin","family":"Hesam-Shariati","sequence":"additional","affiliation":[{"name":"NeuroRecovery Research Hub, School of Psychology, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsey R.","family":"Wilks","sequence":"additional","affiliation":[{"name":"Tori Health, St Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Schroeder","sequence":"additional","affiliation":[{"name":"School of Computer Science and Engineering, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish D.","family":"Diwan","sequence":"additional","affiliation":[{"name":"Spine Service, St George Hospital Campus, Kogarah, New South Wales, Australia"},{"name":"School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Spinal Unit, Discipline of Orthopaedic Surgery and Trauma, Royal Adelaide Hospital, The University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina","family":"Suh","sequence":"additional","affiliation":[{"name":"School of Computer Science and Engineering, University of Washington, Seattle"},{"name":"Microsoft Research, Redmond, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill M.","family":"Newby","sequence":"additional","affiliation":[{"name":"Black Dog Institute and School of Psychology, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Newton-John","sequence":"additional","affiliation":[{"name":"Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Quid\u00e9","sequence":"additional","affiliation":[{"name":"NeuroRecovery Research Hub, School of Psychology, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"McAuley","sequence":"additional","affiliation":[{"name":"Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia"},{"name":"School of Health Sciences, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia M.","family":"Gustin","sequence":"additional","affiliation":[{"name":"NeuroRecovery Research Hub, School of Psychology, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"issue":"10289","key":"zoi250267r2","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1016\/S0140-6736(21)00393-7","article-title":"Chronic pain: an update on burden, best practices, and new advances.","volume":"397","author":"Cohen","year":"2021","journal-title":"Lancet"},{"issue":"4","key":"zoi250267r3","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.ejpain.2005.06.009","article-title":"Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment.","volume":"10","author":"Breivik","year":"2006","journal-title":"Eur J Pain"},{"issue":"36","key":"zoi250267r4","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.15585\/mmwr.mm6736a2","article-title":"Prevalence of chronic pain and high-impact chronic pain among adults\u2014United States, 2016.","volume":"67","author":"Dahlhamer","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"1","key":"zoi250267r5","doi-asserted-by":"publisher","DOI":"10.1080\/19932820.2020.1730550","article-title":"A survey of chronic pain in China.","volume":"15","author":"Yongjun","year":"2020","journal-title":"Libyan J Med"},{"issue":"3","key":"zoi250267r6","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1016\/j.pain.2011.10.023","article-title":"Cognitive dimensions of anger in chronic pain.","volume":"153","author":"Trost","year":"2012","journal-title":"Pain"},{"issue":"3","key":"zoi250267r7","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.pain.2007.09.014","article-title":"Worry and chronic pain: a misdirected problem solving model.","volume":"132","author":"Eccleston","year":"2007","journal-title":"Pain"},{"issue":"9","key":"zoi250267r8","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.jpain.2013.03.002","article-title":"Developing a model of associations between chronic pain, depressive mood, chronic fatigue, and self-efficacy in people with spinal cord injury.","volume":"14","author":"Craig","year":"2013","journal-title":"J Pain"},{"issue":"10","key":"zoi250267r9","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.3390\/healthcare11101368","article-title":"Why does it hurt so much? emotion regulation mediates the association between fibromyalgia symptoms and psychological distress.","volume":"11","author":"Frumer","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"zoi250267r10","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.jpsychores.2018.02.002","article-title":"The role of emotion regulation in chronic pain: a systematic literature review.","volume":"107","author":"Koechlin","year":"2018","journal-title":"J Psychosom Res"},{"issue":"3","key":"zoi250267r11","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1097\/j.pain.0000000000003056","article-title":"Co-occurrence of chronic pain and anxiety\/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities.","volume":"165","author":"De La Rosa","year":"2024","journal-title":"Pain"},{"issue":"20","key":"zoi250267r12","doi-asserted-by":"publisher","first-page":"2433","DOI":"10.1001\/archinte.163.20.2433","article-title":"Depression and pain comorbidity: a literature review.","volume":"163","author":"Bair","year":"2003","journal-title":"Arch Intern Med"},{"issue":"10","key":"zoi250267r13","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1002\/da.20600","article-title":"Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art.","volume":"26","author":"Asmundson","year":"2009","journal-title":"Depress Anxiety"},{"issue":"8","key":"zoi250267r14","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1097\/PSY.0b013e318185c510","article-title":"Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients.","volume":"70","author":"Bair","year":"2008","journal-title":"Psychosom Med"},{"issue":"3","key":"zoi250267r15","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1207\/s15324796abm2903_8","article-title":"Affect and pain in rheumatoid arthritis: do individual differences in affective regulation and affective intensity predict emotional recovery from pain?","volume":"29","author":"Hamilton","year":"2005","journal-title":"Ann Behav Med"},{"issue":"6","key":"zoi250267r16","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1016\/j.jpain.2021.12.008","article-title":"The longitudinal relationship between emotion regulation and pain-related outcomes: results from a large, online prospective study.","volume":"23","author":"Aaron","year":"2022","journal-title":"J Pain"},{"issue":"12","key":"zoi250267r17","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1016\/S2215-0366(24)00278-5","article-title":"Optimising psychiatric care through pain management.","volume":"11","author":"Mendes Neto","year":"2024","journal-title":"Lancet Psychiatry"},{"issue":"8","key":"zoi250267r18","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007407.pub4","article-title":"Psychological therapies for the management of chronic pain (excluding headache) in adults.","volume":"8","author":"Williams","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"zoi250267r19","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1017\/S0048577201393198","article-title":"Emotion regulation: affective, cognitive, and social consequences.","volume":"39","author":"Gross","year":"2002","journal-title":"Psychophysiology"},{"issue":"10","key":"zoi250267r20","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1007\/s11606-010-1418-6","article-title":"Sustained pain reduction through affective self-awareness in fibromyalgia: a randomized controlled trial.","volume":"25","author":"Hsu","year":"2010","journal-title":"J Gen Intern Med"},{"issue":"2","key":"zoi250267r21","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s12160-013-9500-z","article-title":"Effects of anger awareness and expression training versus relaxation training on headaches: a randomized trial.","volume":"46","author":"Slavin-Spenny","year":"2013","journal-title":"Ann Behav Med"},{"issue":"11","key":"zoi250267r22","doi-asserted-by":"publisher","first-page":"2811","DOI":"10.1093\/pm\/pnaa145","article-title":"Emotional awareness and expression therapy achieves greater pain reduction than cognitive behavioral therapy in older adults with chronic musculoskeletal pain: a preliminary randomized comparison trial.","volume":"21","author":"Yarns","year":"2020","journal-title":"Pain Med"},{"issue":"8","key":"zoi250267r23","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1097\/j.pain.0000000000001575","article-title":"Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial.","volume":"160","author":"Boersma","year":"2019","journal-title":"Pain"},{"issue":"6","key":"zoi250267r24","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.15842","article-title":"Emotional awareness and expression therapy vs cognitive behavioral therapy for chronic pain in older veterans: a randomized clinical trial.","volume":"7","author":"Yarns","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"8","key":"zoi250267r25","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1002\/ejp.2268","article-title":"Emotion regulation skills-focused interventions for chronic pain: a systematic review and meta-analysis.","volume":"28","author":"Norman-Nott","year":"2024","journal-title":"Eur J Pain"},{"issue":"2","key":"zoi250267r26","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1176\/appi.psychotherapy.2015.69.2.97","article-title":"The course and evolution of dialectical behavior therapy.","volume":"69","author":"Linehan","year":"2015","journal-title":"Am J Psychother"},{"issue":"1","key":"zoi250267r27","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.sjpain.2009.09.005","article-title":"Applying dialectical behavior therapy to chronic pain: a case study.","volume":"1","author":"Linton","year":"2010","journal-title":"Scand J Pain"},{"issue":"3","key":"zoi250267r28","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.sjpain.2014.05.008","article-title":"A hybrid emotion-focused exposure treatment for chronic pain: a feasibility study.","volume":"5","author":"Linton","year":"2014","journal-title":"Scand J Pain"},{"issue":"5","key":"zoi250267r29","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1093\/pm\/pnaa361","article-title":"Dialectical pain management: feasibility of a hybrid third-wave cognitive behavioral therapy approach for adults receiving opioids for chronic pain.","volume":"22","author":"Barrett","year":"2021","journal-title":"Pain Med"},{"key":"zoi250267r30","doi-asserted-by":"publisher","first-page":"S9","DOI":"10.1097\/01.MIB.0000480106.40651.21","article-title":"P-001 Dialectical behavior therapy for chronic pain in gastrointestinal disorders: a pilot study.","volume":"22","author":"Sysko","year":"2016","journal-title":"Inflamm Bowel Dis"},{"issue":"4","key":"zoi250267r31","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1016\/j.jpain.2021.10.003","article-title":"The no worries trial: efficacy of Online Dialectical Behaviour Therapy Skills Training for Chronic Pain (iDBT-Pain) using a single case experimental design.","volume":"23","author":"Norman-Nott","year":"2022","journal-title":"J Pain"},{"issue":"1","key":"zoi250267r32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/jclp.22114","article-title":"The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature.","volume":"71","author":"Valentine","year":"2015","journal-title":"J Clin Psychol"},{"issue":"2","key":"zoi250267r34","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/S0738-3991(02)00032-0","article-title":"Self-management approaches for people with chronic conditions: a review.","volume":"48","author":"Barlow","year":"2002","journal-title":"Patient Educ Couns"},{"issue":"1","key":"zoi250267r35","doi-asserted-by":"publisher","first-page":"75","DOI":"10.2217\/pmt.15.57","article-title":"Are self-management strategies effective in chronic pain treatment?","volume":"6","author":"Nicholas","year":"2016","journal-title":"Pain Manag"},{"issue":"8","key":"zoi250267r36","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1016\/j.pain.2011.02.012","article-title":"Can pain be managed through the internet? a systematic review of randomized controlled trials.","volume":"152","author":"Bender","year":"2011","journal-title":"Pain"},{"issue":"1","key":"zoi250267r37","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1213\/01.ane.0000268145.52345.55","article-title":"Pain management: a fundamental human right.","volume":"105","author":"Brennan","year":"2007","journal-title":"Anesth Analg"},{"issue":"10","key":"zoi250267r38","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1177\/0004867419857809","article-title":"Service availability and capacity in rural mental health in Australia: analysing gaps using an integrated mental health atlas.","volume":"53","author":"van Spijker","year":"2019","journal-title":"Aust N Z J Psychiatry"},{"key":"zoi250267r39","doi-asserted-by":"publisher","DOI":"10.2196\/41890","article-title":"Internet-delivered dialectical behavioral therapy skills training for chronic pain: protocol for a randomized controlled trial.","volume":"12","author":"Norman-Nott","year":"2023","journal-title":"JMIR Res Protoc"},{"issue":"2","key":"zoi250267r41","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1080\/24750158.2019.1587858","article-title":"Exploring the reasons why university students prefer print over digital texts: an Australian perspective.","volume":"68","author":"Johnston","year":"2019","journal-title":"J Aust Lib Inf Assoc"},{"issue":"4","key":"zoi250267r42","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1007\/s10862-016-9547-9","article-title":"Validation of a brief version of the Difficulties in Emotion Regulation Scale (DERS-18) in five samples.","volume":"38","author":"Victor","year":"2016","journal-title":"J Psychopathol Behav Assess"},{"issue":"3","key":"zoi250267r43","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1002\/bin.1783","article-title":"Autocorrelation and estimates of treatment effect size for single-case experimental design data.","volume":"36","author":"Barnard-Brak","year":"2021","journal-title":"Behav Interv"},{"issue":"3","key":"zoi250267r44","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1093\/biomet\/63.3.581","article-title":"Inference and missing data.","volume":"63","author":"Rubin","year":"1976","journal-title":"Biometrika"},{"issue":"10","key":"zoi250267r46","doi-asserted-by":"publisher","first-page":"1962","DOI":"10.3899\/jrheum.141440","article-title":"Optimal strategies for reporting pain in clinical trials and systematic reviews: recommendations from an OMERACT 12 workshop.","volume":"42","author":"Busse","year":"2015","journal-title":"J Rheumatol"},{"issue":"1-2","key":"zoi250267r48","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.pain.2004.09.012","article-title":"Core outcome measures for chronic pain clinical trials: IMMPACT recommendations.","volume":"113","author":"Dworkin","year":"2005","journal-title":"Pain"},{"issue":"6","key":"zoi250267r49","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.17340","article-title":"Addressing the emotional body in patients with chronic pain.","volume":"7","author":"Karst","year":"2024","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi250267r50","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1111\/jabr.12007","article-title":"A transdiagnostic approach to pain and emotion.","volume":"18","author":"Linton","year":"2013","journal-title":"J Appl Biobehav Res"},{"issue":"8","key":"zoi250267r51","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1097\/AJP.0000000000000313","article-title":"Everyday executive functioning in chronic pain: specific deficits in working memory and emotion control, predicted by mood, medications, and pain interference.","volume":"32","author":"Baker","year":"2016","journal-title":"Clin J Pain"},{"key":"zoi250267r52","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jpsychires.2014.11.012","article-title":"Emotion dysregulation mediates the relationship between lifetime cumulative adversity and depressive symptomatology.","volume":"61","author":"Abravanel","year":"2015","journal-title":"J Psychiatr Res"},{"issue":"6","key":"zoi250267r53","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1097\/AJP.0000000000000185","article-title":"A systematic review of technology-assisted self-management interventions for chronic pain: looking across treatment modalities.","volume":"31","author":"Heapy","year":"2015","journal-title":"Clin J Pain"},{"issue":"1","key":"zoi250267r54","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7.1.e11","article-title":"The law of attrition.","volume":"7","author":"Eysenbach","year":"2005","journal-title":"J Med Internet Res"},{"issue":"6","key":"zoi250267r55","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2104","article-title":"Persuasive system design does matter: a systematic review of adherence to web-based interventions.","volume":"14","author":"Kelders","year":"2012","journal-title":"J Med Internet Res"},{"issue":"1","key":"zoi250267r56","doi-asserted-by":"publisher","DOI":"10.1080\/23311908.2022.2060629","article-title":"Overcoming difficulties in measuring emotional regulation: assessing and comparing the psychometric properties of the DERS long and short forms.","volume":"9","author":"Burton","year":"2022","journal-title":"Cogent Psychol"},{"key":"zoi250267r1","volume-title":"Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms","author":"Merskey","year":"1994","edition":"2nd ed"},{"key":"zoi250267r33","author":"Dyurich","year":"2016"},{"key":"zoi250267r40","volume-title":"DBT Skills Training Manual","author":"Linehan","year":"2015","edition":"2nd ed"},{"key":"zoi250267r45","unstructured":"The R project for statistical computing. R Foundation; 2024. Accessed September 1, 2024. https:\/\/www.R-project.org\/"},{"key":"zoi250267r47","unstructured":"Beck? AT, Steer? RA, Brown? G. Beck Depression Inventory\u2013II. APA PsycTests. 1996. Accessed January 2022. https:\/\/psycnet.apa.org\/doiLanding?doi=10.1037%2Ft00742-000"},{"key":"zoi250267r57","unstructured":"PainAustralia. The cost of pain in Australia. 2019. Accessed October 1, 2024. https:\/\/www.painaustralia.org.au\/static\/uploads\/files\/the-cost-of-pain-in-australia-launch-20190404-wfrsaslpzsnh.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2833582\/normannott_2025_oi_250267_1745870510.57494.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T15:00:32Z","timestamp":1746543632000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2833582"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":57,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.6908","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}