{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:35:42Z","timestamp":1792233342190,"version":"4.4.0"},"reference-count":62,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T00:00:00Z","timestamp":1579651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The relevance of post\u2010traumatic stress disorder (PTSD) symptoms to outcomes of cognitive behavioural therapy (CBT) for chronic pain is unclear. This study examines whether (a) traumatic exposure or the severity of PTSD symptoms at pre\u2010treatment predicts the outcomes (pain intensity\/interference), (b) participation in this treatment is associated with reduced PTSD symptoms and (c) any observed changes in PTSD symptoms are mediated by changes in psychological mechanisms that have been shown to be of importance to PTSD and chronic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were 159 chronic pain patients who were consecutively admitted for a multidisciplinary, group\u2010based CBT program at the Pain Rehabilitation Unit at Sk\u00e5ne University Hospital. A self\u2010report measure of traumatic exposure and PTSD symptoms was administered before and after treatment, and at a 12\u2010month follow\u2010up, along with measures of depression, anxiety, pain intensity, pain interference, psychological inflexibility, life control and kinesiophobia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Traumatic exposure and PTSD symptom severity did not predict pain intensity or interference at 12\u2010month follow\u2010up. There were no overall significant changes in PTSD symptom severity at post\u2010treatment or follow\u2010up, but 24.6% of the participants showed potential clinically significant change at follow\u2010up. Psychological inflexibility mediated the changes that occurred in PTSD symptoms during treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neither traumatic exposure nor baseline symptoms of PTSD predicted the treatment outcomes examined here. Despite improvements in both comorbid depression and anxiety, participation in this pain\u2010focused CBT program was not associated with improvements in comorbid PTSD. To the extent that changes in PTSD symptoms did occur, these were mediated by changes in psychological inflexibility during treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Pain\u2010focused CBT programs yield clinically meaningful improvements in pain and comorbid symptoms of depression and anxiety, but may have little effect on comorbid PTSD. This raises the issue of whether current pain\u2010focused CBT programs can be modified to improve outcomes for comorbid conditions, perhaps by better targeting of psychological flexibility, and\/or whether separate treatment of PTSD may be associated with improved pain outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1530","type":"journal-article","created":{"date-parts":[[2020,1,6]],"date-time":"2020-01-06T12:45:07Z","timestamp":1578314707000},"page":"807-817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Treatment outcomes in group\u2010based cognitive behavioural therapy for chronic pain: An examination of PTSD symptoms"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9220-3176","authenticated-orcid":false,"given":"Sophia","family":"\u00c5kerblom","sequence":"first","affiliation":[{"name":"Department of Pain Rehabilitation Sk\u00e5ne University Hospital Lund Sweden"},{"name":"Department of Psychology Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Perrin","sequence":"additional","affiliation":[{"name":"Department of Psychology Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Rivano","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Pain Rehabilitation Sk\u00e5ne University Hospital Lund Sweden"},{"name":"Department of Health Sciences Lund University Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance M.","family":"McCracken","sequence":"additional","affiliation":[{"name":"Department of Psychology Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.03.007"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-017-9641-8"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000561"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v5.23235"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370204701004"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.20600"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0021263"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v5.25547"},{"key":"e_1_2_9_10_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9513-7"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2007.01.022"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PSY.0000024232.11538.54"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"343","article-title":"Strategies for dealing with missing data in clinical trials: From design to analysis","volume":"86","author":"Dziura J. 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