{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T14:34:07Z","timestamp":1783089247080,"version":"3.54.6"},"reference-count":55,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T00:00:00Z","timestamp":1689811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a significant research gap with respect to the long\u2010term sustainability of psychological treatment effects in chronic pain patients. This study aimed to investigate long\u2010term treatment effects of two psychological treatments: cognitive behavioural therapy (CBT) as a broad\u2010spectrum approach and exposure as a specific intervention for fear\u2010avoidant pain patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with chronic low back pain were randomized to CBT or exposure in vivo. Long\u2010term follow\u2010up (LTFU) data were available for 64 patients up to 8\u2009years after treatment, with a response rate of 73%. The primary outcomes were pain\u2010related disability and pain intensity and secondary outcomes were emotional distress, psychological flexibility, catastrophizing and pain\u2010related fear. The data analysis was performed with longitudinal multilevel modelling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multilevel analyses showed improvements in all primary outcomes as well as all secondary outcomes from pre\u2010treatment to LTFU for both treatments. The mean proportion of cases meeting reliable and clinical improved criteria in all primary outcome was 36% (range: 22%\u201346%) in the exposure group and 50% (range: 33%\u201360%) in the CBT group. Dropout analyses revealed significantly higher deterioration rates over time. Pre\u2010treatment to LTFU effect sizes of the primary outcomes ranged from 0.54 to 1.59.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results indicate that the effects of psychological treatments might be stable over several years. Treatment gains for exposure as a stand\u2010alone treatment seem to be of shorter duration than a general CBT intervention. Thus, psychological treatments might offer a promising and sustainable long\u2010term perspective for patients with chronic back pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>The long\u2010term stability of treatment effects is a highly neglected issue despite its inherent importance in the context of chronic pain. This study is the first to investigate treatment effects of cognitive behavioural therapy and in vivo exposure in chronic back pain sufferers up to 8\u2009years after treatment. The findings contribute to an understanding of the sustainability of psychological cognitive behavioural therapy\u2010based intervention effects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2160","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T10:49:46Z","timestamp":1689850186000},"page":"83-94","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Sustainability of cognitive behavioural interventions for chronic back pain: A long\u2010term follow\u2010up"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2683-7541","authenticated-orcid":false,"given":"Jenny","family":"Riecke","sequence":"first","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy University of Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7019-2250","authenticated-orcid":false,"given":"Winfried","family":"Rief","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy University of Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1621-9851","authenticated-orcid":false,"given":"Gunnar","family":"Lemmer","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology and Psychotherapy University of Marburg  Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia A.","family":"Glombiewski","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Koblenz\u2010Landau  Landau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-015-0641-z"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-018-1000-1"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2009.06.008"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(99)00175-8"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001575"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MRR.0000000000000467"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001401"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000164099.92112.29"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(86)80060-0"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02530415"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.09.012"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00138-0"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269215516639356"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1026\/\/0084-5345.28.4.280"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2019.10.008"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000298"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199309000-00006"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-019-05967-6"},{"key":"e_1_2_9_20_1","volume-title":"HADS\u2010D: Hospital anxiety and depression scale. 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