Highlights
- •Poorer neuropsychological performance related to worse baseline functioning.
- •Relatively low neuropsychological performance not contraindicated for acceptance and commitment therapy.
- •Executive function and processing speed were important moderators of outcomes.
Abstract
Neuropsychological (NP) performance has been associated with psychosocial treatment
outcomes in nonpain conditions, but has never been investigated in chronic pain. We
performed a secondary analysis on the association of baseline NP performance with
treatment outcomes among veterans with chronic pain (N = 117) undergoing an 8-week
acceptance and commitment therapy (ACT) intervention. Participants completed measures
of pain interference, pain severity, quality of life, activity levels, depression,
and pain-related anxiety at baseline, midtreatment, and post-treatment. Executive
functioning, working memory, processing speed, learning, and verbal memory were assessed
at baseline. All study measures significantly improved from baseline to post-treatment.
NP performance was related to changes in depression and pain-related anxiety during
treatment. Specifically, relatively lower executive functioning and processing speed
was associated with greater decreases in depressive symptoms, and relatively lower
processing speed was associated with greater decreases in pain-related anxiety. Consistent
with research in nonpain conditions, those with relatively lower NP functioning received
greater benefit from psychosocial treatment, although most study outcomes did not
differ as a function of NP performance. Our results suggest relatively lower NP functioning
is not contraindicated for participation in psychosocial interventions like ACT but
instead may be associated with greater relief.
Perspective
This study suggests that NP functioning is unrelated to changes in pain interference
associated with ACT, and that those with relatively lower NP functioning may experience
greater reductions in depressive symptoms and pain-related anxiety. This article contains
important information for researchers and clinicians interested in cognition and chronic
pain.
Key words
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Article info
Publication history
Published online: February 26, 2018
Accepted:
February 14,
2018
Received in revised form:
January 12,
2018
Received:
September 27,
2017
Footnotes
This study was supported by Veterans Affairs Rehabilitation R&D grant F6891R and the Office of Academic Affiliations, Department of Veterans Affairs.
The authors have no conflicts of interest to declare.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Pain Society
