Highlights
- •We examined the validity of patient impression of change ratings following an interdisciplinary treatment for chronic pain.
- •Global and domain-specific patient impression of change ratings loaded onto a single component.
- •Patient Global Impression of Change ratings were strongly influenced by patients' experienced improvements in physical activities and mood.
- •Both global and domain-specific impression of change ratings might be important to consider.
Abstract
The Patient Global Impression of Change (PGIC) measure has frequently been used as
an indicator of meaningful change in treatments for chronic pain. However, limited
research has examined the validity of PGIC items despite their wide adoption in clinical
trials for pain. Additionally, research has not yet examined predictors of PGIC ratings
following psychologically based treatment for pain. The purpose of the present study
was to examine the validity, factor structure, and predictors of PGIC ratings following
an interdisciplinary psychologically based treatment for chronic pain. Patients with
chronic pain (N = 476) completed standard assessments of pain, daily functioning,
and depression before and after a 4-week treatment program based on the principles
of acceptance and commitment therapy. Following the program, patients rated 1 item
assessing their impression of change overall and several items assessing their impression
of more specific changes: physical and social functioning, work-related activities,
mood, and pain. Results indicated that the global and specific impression of change
items represent a single component. In the context of the acceptance and commitment
therapy–based treatment studied here, overall PGIC ratings appeared to be influenced
to a greater degree by patients' experienced improvements in physical activities and
mood than by improvements in pain. The findings suggest that in addition to a single
overall PGIC rating, domain-specific items may be relevant for some treatment trials.
Perspective
This article reports on the validity and predictors of patients' impression of change
ratings following interdisciplinary psychologically based treatment for pain. In addition
to a single overall PGIC rating, domain-specific items may be important for clinicians
and researchers to consider depending on the focus of treatment.
Key words
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Article info
Publication history
Published online: March 04, 2015
Accepted:
February 22,
2015
Received in revised form:
February 21,
2015
Received:
January 5,
2015
Footnotes
W.S. is supported by the International Association for the Study of Pain John J. Bonica Trainee Fellowship grant.
The authors declare no conflicts of interest associated with this study.
Identification
Copyright
© 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.
