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Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study
Örebro University, School of Law, Psychology and Social Work. (CHAMP)ORCID iD: 0000-0002-3887-6281
Örebro University, School of Law, Psychology and Social Work. (CHAMP)
Private person. (CHAMP)
Örebro University, School of Law, Psychology and Social Work. (CHAMP)ORCID iD: 0000-0002-9688-5805
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2017 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed) Published
Abstract [en]

In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimaltreatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarchingaim of this study was to test an internet delivered therapist guided transdiagnostic treatment withtelephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of EmotionalDisorders was used as an intervention for pain patients with residual pain problems and comorbid emotionalproblems after having received a multimodal pain rehabilitation. The study used a replicated AB single caseexperimental design (N =5; 3 females). Outcome measures were depressive and general anxiety symptoms, painintensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance) andpatient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP) indicate a decrease of anxiety forthree participants and a decrease of depression for four participants. Decreases were small and did not alwaysreach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two outof four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnosticcriteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patientsatisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support maybe a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, theeffects are unclear. The gap between high patient satisfaction and small changes in symptomatology should beexplored further.

Place, publisher, year, edition, pages
Elsevier, 2017. Vol. 10, p. 54-64
Keywords [en]
Internet delivered treatment; pain; transdiagnostic; emotional comorbidity; single case
National Category
Other Medical Sciences not elsewhere specified
Research subject
Psychology
Identifiers
URN: urn:nbn:se:oru:diva-62356DOI: 10.1016/j.invent.2017.10.004Scopus ID: 2-s2.0-85032807121OAI: oai:DiVA.org:oru-62356DiVA, id: diva2:1156738
Projects
SÅSAvailable from: 2017-11-14 Created: 2017-11-14 Last updated: 2018-09-12Bibliographically approved
In thesis
1. Understanding Comorbid Pain and Emotions: A transdiagnostic approach
Open this publication in new window or tab >>Understanding Comorbid Pain and Emotions: A transdiagnostic approach
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Experiencing pain, including an emotional reaction, is part of being hu­man. Emotional comorbidity is common in pain patients, and corre­lated to higher symptomatology and worse treatment outcome. The shared vulnerability model suggests that many vulnerability and main­taining factors may be involved in both pain and emotional problems. Hence, they may be transdiagnostic. Since our knowledge about these shared factors is lacking, potential targets for risk assessment, preven­tion, and treatment are likely underutilized. The overarching aim of this dissertation was to further our understanding of comorbid musculo­skeletal pain and emotional problems by investigating the role of trans­diagnostic factors. Specifically, it was studied if levels of shared vulner­abilities (negative affect and anxiety sensitivity) and symptomatology covary in pain patients depending on the occurrence of comorbid social anxiety symptoms (Study I); if peer-related stress predicts musculoskel­etal pain problems over time in adolescents, and if this is mediated by worry and moderated by gender (Study II); and if symptomatology can be decreased in pain patients with comorbid emotional problems by using an internet delivered unified protocol for emotional disorders (Study III). Results show that vulnerabilities covaried with comorbid pain and social anxiety. Also, peer-related stress predicted musculoskel­etal pain problems in adolescents and was mediated by worry for girls. However, the internet-delivered unified protocol did not unequivocally decrease symptomatology. In sum, the studies in this dissertation pro­vide partial support for the role of transdiagnostic factors in comorbid musculoskeletal pain and emotional problems. A transdiagnostic ap­proach may offer a parsimonious understanding of the  development and maintenance of this comorbid symptomatology.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 98
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 40
Keywords
Transdiagnostic approach, musculoskeletal pain, emotions, comorbidity, shared vulnerability model, social factors, gender
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-66696 (URN)978-91-7529-250-2 (ISBN)
Public defence
2018-06-08, Örebro universitet, Långhuset, Hörsal L2, Fakultetsgatan 1, Örebro, 09:15 (English)
Opponent
Supervisors
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-06-08Bibliographically approved

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Wurm, MatildaKlein Strandberg, EsterTillfors, MariaHolländare, FredrikBoersma, Katja
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