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Changes in pain coping, catastrophizing, and coping efficacy after cognitive-behavioral therapy in children and adolescents with juvenile fibromyalgia.
J Pain 2013; 14(5):492-501JP

Abstract

A recent randomized multisite clinical trial found that cognitive-behavioral therapy (CBT) was significantly more effective than fibromyalgia education (FE) in reducing functional disability in adolescents with juvenile fibromyalgia (JFM). The primary objective of this study was to examine the psychological processes of CBT effectiveness by evaluating changes in pain coping, catastrophizing, and coping efficacy and to test these changes as mediators of continued improvements in functional disability and depressive symptoms at 6-month follow-up. One hundred adolescents (11-18 years old) with JFM completed the clinical trial. Coping, catastrophizing, and coping efficacy (Pain Coping Questionnaire) and the outcomes of functional disability (Functional Disability Inventory) and depressive symptoms (Children's Depression Inventory) were measured at baseline, posttreatment, and 6-month follow-up. Participants in both conditions showed significant improvement in coping, catastrophizing, and efficacy by the end of the study, but significantly greater improvements were found immediately following treatment for those who received CBT. Treatment gains were maintained at follow-up. Baseline to posttreatment changes in coping, catastrophizing, and efficacy were not found to mediate improvements in functional disability or depressive symptoms from posttreatment to follow-up. Future directions for understanding mechanisms of CBT effectiveness in adolescents with chronic pain are discussed.

PERSPECTIVE

CBT led to significant improvements in pain coping, catastrophizing, and efficacy that were sustained over time in adolescents with juvenile fibromyalgia. Clinicians treating adolescents with JFM should focus on teaching a variety of adaptive coping strategies to help patients simultaneously regain functioning and improve mood.

Authors+Show Affiliations

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. Susmita.Kashikar-Zuck@cchmc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23541069

Citation

Kashikar-Zuck, Susmita, et al. "Changes in Pain Coping, Catastrophizing, and Coping Efficacy After Cognitive-behavioral Therapy in Children and Adolescents With Juvenile Fibromyalgia." The Journal of Pain : Official Journal of the American Pain Society, vol. 14, no. 5, 2013, pp. 492-501.
Kashikar-Zuck S, Sil S, Lynch-Jordan AM, et al. Changes in pain coping, catastrophizing, and coping efficacy after cognitive-behavioral therapy in children and adolescents with juvenile fibromyalgia. J Pain. 2013;14(5):492-501.
Kashikar-Zuck, S., Sil, S., Lynch-Jordan, A. M., Ting, T. V., Peugh, J., Schikler, K. N., ... Lovell, D. J. (2013). Changes in pain coping, catastrophizing, and coping efficacy after cognitive-behavioral therapy in children and adolescents with juvenile fibromyalgia. The Journal of Pain : Official Journal of the American Pain Society, 14(5), pp. 492-501. doi:10.1016/j.jpain.2012.12.019.
Kashikar-Zuck S, et al. Changes in Pain Coping, Catastrophizing, and Coping Efficacy After Cognitive-behavioral Therapy in Children and Adolescents With Juvenile Fibromyalgia. J Pain. 2013;14(5):492-501. PubMed PMID: 23541069.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in pain coping, catastrophizing, and coping efficacy after cognitive-behavioral therapy in children and adolescents with juvenile fibromyalgia. AU - Kashikar-Zuck,Susmita, AU - Sil,Soumitri, AU - Lynch-Jordan,Anne M, AU - Ting,Tracy V, AU - Peugh,James, AU - Schikler,Kenneth N, AU - Hashkes,Philip J, AU - Arnold,Lesley M, AU - Passo,Murray, AU - Richards-Mauze,Margaret M, AU - Powers,Scott W, AU - Lovell,Daniel J, Y1 - 2013/03/26/ PY - 2012/02/27/received PY - 2012/12/03/revised PY - 2012/12/29/accepted PY - 2013/4/2/entrez PY - 2013/4/2/pubmed PY - 2013/12/16/medline SP - 492 EP - 501 JF - The journal of pain : official journal of the American Pain Society JO - J Pain VL - 14 IS - 5 N2 - UNLABELLED: A recent randomized multisite clinical trial found that cognitive-behavioral therapy (CBT) was significantly more effective than fibromyalgia education (FE) in reducing functional disability in adolescents with juvenile fibromyalgia (JFM). The primary objective of this study was to examine the psychological processes of CBT effectiveness by evaluating changes in pain coping, catastrophizing, and coping efficacy and to test these changes as mediators of continued improvements in functional disability and depressive symptoms at 6-month follow-up. One hundred adolescents (11-18 years old) with JFM completed the clinical trial. Coping, catastrophizing, and coping efficacy (Pain Coping Questionnaire) and the outcomes of functional disability (Functional Disability Inventory) and depressive symptoms (Children's Depression Inventory) were measured at baseline, posttreatment, and 6-month follow-up. Participants in both conditions showed significant improvement in coping, catastrophizing, and efficacy by the end of the study, but significantly greater improvements were found immediately following treatment for those who received CBT. Treatment gains were maintained at follow-up. Baseline to posttreatment changes in coping, catastrophizing, and efficacy were not found to mediate improvements in functional disability or depressive symptoms from posttreatment to follow-up. Future directions for understanding mechanisms of CBT effectiveness in adolescents with chronic pain are discussed. PERSPECTIVE: CBT led to significant improvements in pain coping, catastrophizing, and efficacy that were sustained over time in adolescents with juvenile fibromyalgia. Clinicians treating adolescents with JFM should focus on teaching a variety of adaptive coping strategies to help patients simultaneously regain functioning and improve mood. SN - 1528-8447 UR - https://www.unboundmedicine.com/medline/citation/23541069/Changes_in_pain_coping_catastrophizing_and_coping_efficacy_after_cognitive_behavioral_therapy_in_children_and_adolescents_with_juvenile_fibromyalgia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1526-5900(13)00034-5 DB - PRIME DP - Unbound Medicine ER -