- •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.
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.
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.
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Published online: February 26, 2018
Accepted: February 14, 2018
Received in revised form: January 12, 2018
Received: September 27, 2017
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.
Published by Elsevier Inc. on behalf of the American Pain Society