Are emotion regulation skills related to adjustment among people with chronic pain, independent of pain coping?

Key Laboratory of Cognition & Personality, Southwest University, Chongqing, 715400, PR China.
European journal of pain (London, England) (Impact Factor: 3.22). 06/2011; 16(1):105-14. DOI: 10.1016/j.ejpain.2011.05.011
Source: PubMed

ABSTRACT Although emotion regulation capacities have been linked to adjustment among people with chronic pain, researchers have yet to determine whether these capacities are related to functioning independent of established facets of pain coping. The present study was designed to address this gap. A sample 128 Australian adults with chronic pain (44 men, 84 women) completed self-report measures of adjustment (quality of life, negative affect, and pain-related disability), pain coping, and features of emotion regulation (emotion appraisal, perceived efficacy in emotion regulation, emotion utilization). Hierarchical multiple regression analyses indicated that efficacy in emotion regulation was related to quality of life and reduced negative affect even after statistically controlling for effects of other measures of adjustment, pain coping efficacy, and pain coping. Conversely, features of emotion regulation did not improve the prediction model for pain-related disability. Findings suggest emotion regulation capacities may have a unique role in the prediction of specific facets of adjustment among people with chronic pain.


Available from: Todd Jackson, Jun 12, 2015
1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Studies demonstrate that CBT is effective in treating patients with multiple somatoform symptoms (MSS), but by now, the interventions consistently did not exceed medium effect sizes. Since many MSS patients seem to lack emotional awareness, the integration of emotion regulation training could enhance the effects of common psychological interventions. The management of feelings should be enhanced by enriching CBT with emotion regulation strategies like non-judgmental perception, acceptance, and mindfulness. The objective of this study was to validate the ENCERT (Enriching CBT with Emotion Regulation Training) manual, to demonstrate its feasibility and to compare the changes over time with CBT and ENCERT. Patients and Methods: In a non-randomized group study, 20 patients in ENCERT and 22 in CBT (3 medically unexplained somatic symptoms, 6 months) attended 20 weekly sessions of individual psychotherapy in an outpatient setting. Assessments took place before beginning and after completion of therapy. Primary outcomes were the Screening of Somatization Disorder (SOMS-7T), emotion regulation skills, and visual analogue scales (VAS) assessing symptom intensity and subjective impairment. Results: Both groups showed significant improvement in the somatization severity index (CBT d = 0.46; ENCERT d = 0.70), as well as in the somatization symptom count (CBT d = 0.50; ENCERT d = 0.72). There were no significant group differences after completion of therapy: Controlling for base-line variables, there was an indication for significant difference between groups in favor of ENCERT in the somatization severity index after completion of therapy (ANCOVA: F (1.37) = 4.058, p = 0.051). Additionally, patients significantly improved during ENCERT in intensity (d = 0.59) and in impairment (d = 1.25) of symptoms, and they reported to acquire greater emotion regulation competence (d = 1.14). Conclusion: Patients with MSS improved during ENCERT and CBT with tendentially larger effect sizes for ENCERT but higher baseline value in depression and anxiety. However, we were not able to find group differences. This might be due to a lack of statistical power. Therefore, our next step is the implementation of a large randomized, controlled multicenter trial.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hintergrund: Kognitive Verhaltenstherapie (KVT) ist bei Patienten mit multiplen somatoformen Symptomen (MSS) erwiesenermaßen wirksam, bisher jedoch nur mit moderaten Effekten. Da sich bei diesen Patienten Hinweise für ein Emotionswahrnehmungsdefizit und Regulationsdefizit finden, wurde an der Universität Marburg ein Behandlungsmanual für Patienten mit MSS entwickelt, das KVT-Elemente und ein spezielles Emotionsregulationstraining verbindet. In diesem soll der Umgang mit Emotionen durch Strategien der bewertungsfreien Wahrnehmung, Akzeptanz und Achtsamkeit gefördert werden. Ziel der vorliegenden Studie war, die Durchführbarkeit des Behandlungsprogramms ENCERT (Enriching CBT with Emotion Regulation Training) zu testen sowie die Veränderungen über die Zeit unter ENCERT mit denen einer klassischen KVT zu vergleichen. Patienten und Methoden: 20 ENCERT-Patienten und 22 KVT-Patienten (mit ≥3 somatoformen Symptomen, seit ≥6 Monaten) nahmen im Rahmen einer nicht randomisierten Gruppenvergleichsstudie an 20 wöchentlichen Einzeltherapie-sitzungen im ambulanten Setting teil. Zu Therapiebeginn und-ende wurden relevante Daten erhoben. Die primären Outcomemaße waren das Screening für somatoforme Störungen (SOMS-7T), der Fragebogen zur Selbsteinschätzung emotionaler Kompetenzen (SEK-27) und visuelle Analogskalen (VAS) zur Einschätzung der Symptomintensität und zur empfundenen Beeinträchtigung. Ergebnisse: Beide Gruppen verbesserten sich im Therapieverlauf signifikant bezüglich der Beeinträchtigungsintensität (ENCERT d = 0,70; KVT d = 0,46) und Beschwerdeanzahl (ENCERT d = 0,72; KVT d = 0,50). Gruppenunterschiede zu Therapieende zeigten sich nicht: Unter Berücksichtigung klinisch relevanter Baselinevariablen zeigte sich zu Therapieende ein Hinweis auf einen signifikanten Unterschied in der Beein-trächtigungsintensität (ANCOVA: F (1,37) = 4,058, p = 0,051; ENCERT überlegen). ENCERT-Patienten verbesserten sich zudem signifikant auf stündlich erhobenen visuellen Analogskalen (Beschwerdeintensität d = 0,59; Beeinträchtigung durch Beschwerden d = 1,25) und in ihren Emotionsregulationskompetenzen (d = 1,14). Schlussfolgerung: Patienten mit MSS verbesserten sich während ENCERT und KVT, mit tendenziell höheren Effektstärken für ENCERT, jedoch auch höheren Ausgangswerten in Depressivität und Angst. Gruppenunterschiede zeigten sich nicht, möglicherweise aufgrund geringer Power. Diese Ergebnisse ermutigen zur Durchführung einer größeren randomisierten und kontrollierten Multicenterstudie.
    Verhaltenstherapie 02/2015; DOI:10.1159/000371526 · 0.51 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Research suggests that emotions and emotion regulation processes can influence both the sensory (e.g., intensity) and the affective (unpleasantness) components of pain. The purpose of this study was to investigate the factor structure and validity of the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) in medical sample with persistent pain. Data were collected from 207 chronic pain patients (82.6% female; mean age = 51.96). We applied confirmatory factor analysis (CFA) to test measurement model of emotion dysregulation and CFA with covariates to test construct and convergent validity of the DERS. The original factor structure of the DERS was not supported in our medical sample. However, after some modifications the DERS yielded good fit. Validity of the DERS was confirmed. All the subscales had significant relationship with depression measure, and all the subscales except one correlated with Difficulties in Identifying Feelings component of alexithymia. The DERS proved to be an adequate measure of clinically relevant dimensions of emotional dysregulation in chronic pain patients.
    Journal of Clinical Psychology 06/2014; 70(6). DOI:10.1002/jclp.22036 · 2.12 Impact Factor