{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:10:24Z","timestamp":1792113024183,"version":"4.4.0"},"reference-count":61,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The medical and scientific communities struggle to understand chronic pain and find effective treatments. Multimodal approaches are encouraging but show significant individual differences. Methods: Seventy-eight persons (56 women) with chronic pain received Acceptance and Commitment Therapy and provided blood samples before and after treatment. The participants completed surveys with the blood sampling. Blood plasma was analyzed for IL-6 and TNF-\u03b1 levels with the Olink Inflammation Panel (Olink Bioscience Uppsala, Sweden). The treatment effects and moderating effects of low-grade inflammation on changes in outcomes were analyzed using linear mixed models. Results: Pain interference (p &lt; 0.001) and psychological inflexibility (p &lt; 0.001) improved significantly during treatment, but pain intensity did not (p = 0.078). Cytokine levels did not change over the course of the treatment (IL-6\/TNF-\u03b1 p = 0.086\/0.672). Mean baseline levels of IL-6 and TNF-\u03b1 moderated improvement in psychological inflexibility during the course of treatment (p = 0.044), but cytokine levels did not moderate changes in pain interference (p = 0.205) or pain intensity (p = 0.536). Conclusions: Higher baseline inflammation levels were related to less improvement in psychological inflexibility. Low-grade inflammation may be one factor underlying the variability in behavioral treatment in chronic pain.<\/jats:p>","DOI":"10.3390\/jcm11092285","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T03:46:11Z","timestamp":1650512771000},"page":"2285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Baseline Pro-Inflammatory Cytokine Levels Moderate Psychological Inflexibility in Behavioral Treatment for Chronic Pain"],"prefix":"10.3390","volume":"11","author":[{"given":"Bianka","family":"Karshikoff","sequence":"first","affiliation":[{"name":"Department of Social Studies, University of Stavanger, 4021 Stavanger, Norway"},{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0307-3673","authenticated-orcid":false,"given":"Jenny","family":"\u00c5str\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"},{"name":"Medical Unit Medical Psychology, Theme Women\u2019s Health and Allied Health Professionals, Karolinska University Hospital, 171 76 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Holmstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"},{"name":"Medical Unit Medical Psychology, Theme Women\u2019s Health and Allied Health Professionals, Karolinska University Hospital, 171 76 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Lekander","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"},{"name":"Stress Research Institute, Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike K.","family":"Kemani","sequence":"additional","affiliation":[{"name":"Medical Unit Medical Psychology, Theme Women\u2019s Health and Allied Health Professionals, Karolinska University Hospital, 171 76 Stockholm, Sweden"},{"name":"Stress Research Institute, Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikard K.","family":"Wicksell","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, 171 77 Stockholm, Sweden"},{"name":"Pain Clinic, Capio St. G\u00f6ran Hospital, 112 19 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","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. 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