Predictors of Outcome Following Multidisciplinary Treatment of Chronic Pain: Effects of Changes in Perceived Disability and Depression

The goal of this study was to evaluate the validity of the cognitive-behavioral approach for treating chronic pain. We examined whether changes in a specific cognitive process factor (i.e., perceived disability) accounted for variance in pre- to posttreatment improvements in outcome variables even after controlling for changes in a general factor (i.e., depression). Subjects were 82 patients who completed a multidisciplinary chronic pain program. Results showed that perceived (pain) disability, depression, and pain severity decreased while general activity level and functional level increased from pre-to post-treatment (all p's < .05). Regressions revealed that perceived disability change scores predicted unique variance in pain severity and functional level changes after controlling for variance accounted for by depression changes. Results support the cognitive-behavioral approach: Decreases in perceived disability may act as a distinct therapeutic mechanism through which treatment produces improvements in outcome variables.