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Background factors for chronic low back pain resistant to cognitive behavioral therapy
This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) or non-ada...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050286/ https://www.ncbi.nlm.nih.gov/pubmed/33859240 http://dx.doi.org/10.1038/s41598-021-87239-2 |
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author | Shimizu, Keisuke Inage, Kazuhide Orita, Sumihisa Eguchi, Yawara Shiga, Yasuhiro Koda, Masao Aoki, Yasuchika Kotani, Toshiaki Akazawa, Tsutomu Furuya, Takeo Nakamura, Junichi Takahashi, Hiroshi Suzuki-Narita, Miyako Maki, Satoshi Hagiwara, Shigeo Inoue, Masahiro Norimoto, Masaki Kinoshita, Hideyuki Sato, Takashi Sato, Masashi Enomoto, Keigo Takaoka, Hiromitsu Mizuki, Norichika Hozumi, Takashi Tsuchiya, Ryuto Kim, Geundong Otagiri, Takuma Mukaihata, Tomohito Hishiya, Takahisa Ohtori, Seiji |
author_facet | Shimizu, Keisuke Inage, Kazuhide Orita, Sumihisa Eguchi, Yawara Shiga, Yasuhiro Koda, Masao Aoki, Yasuchika Kotani, Toshiaki Akazawa, Tsutomu Furuya, Takeo Nakamura, Junichi Takahashi, Hiroshi Suzuki-Narita, Miyako Maki, Satoshi Hagiwara, Shigeo Inoue, Masahiro Norimoto, Masaki Kinoshita, Hideyuki Sato, Takashi Sato, Masashi Enomoto, Keigo Takaoka, Hiromitsu Mizuki, Norichika Hozumi, Takashi Tsuchiya, Ryuto Kim, Geundong Otagiri, Takuma Mukaihata, Tomohito Hishiya, Takahisa Ohtori, Seiji |
author_sort | Shimizu, Keisuke |
collection | PubMed |
description | This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) or non-adaptation group (without VAS improvement). The patients were analyzed using various psychological tests. CBT improved depressive symptoms and catastrophic thinking; however, they were not correlated with the VAS and did not directly affect low back pain improvement. The non-adaptation group showed an unexplainable/vague sense of anxiety; an excessive focus on searching for pain; a strong intimacy desire; a strong tendency of medical dependency; and fantasy or distortion of the actual experience, especially self-image. Moreover, the patients showed a low ability to objectively express or attribute meaning to pain due to poor language skills, attention-deficit hyperactivity disorder, and emotional value judgment. Individuals with the aforementioned characteristics of pre-CBT psychological tests should select a different treatment approach given the high poor-adaption possibility. Even patients with depressive or anxious symptoms are not necessarily adaptable for CBT. Therefore, pre-CBT tests for treatment suitability are necessary. Future studies should establish a protocol for psychotherapy suitable for the non-adaptation group. |
format | Online Article Text |
id | pubmed-8050286 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-80502862021-04-16 Background factors for chronic low back pain resistant to cognitive behavioral therapy Shimizu, Keisuke Inage, Kazuhide Orita, Sumihisa Eguchi, Yawara Shiga, Yasuhiro Koda, Masao Aoki, Yasuchika Kotani, Toshiaki Akazawa, Tsutomu Furuya, Takeo Nakamura, Junichi Takahashi, Hiroshi Suzuki-Narita, Miyako Maki, Satoshi Hagiwara, Shigeo Inoue, Masahiro Norimoto, Masaki Kinoshita, Hideyuki Sato, Takashi Sato, Masashi Enomoto, Keigo Takaoka, Hiromitsu Mizuki, Norichika Hozumi, Takashi Tsuchiya, Ryuto Kim, Geundong Otagiri, Takuma Mukaihata, Tomohito Hishiya, Takahisa Ohtori, Seiji Sci Rep Article This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) or non-adaptation group (without VAS improvement). The patients were analyzed using various psychological tests. CBT improved depressive symptoms and catastrophic thinking; however, they were not correlated with the VAS and did not directly affect low back pain improvement. The non-adaptation group showed an unexplainable/vague sense of anxiety; an excessive focus on searching for pain; a strong intimacy desire; a strong tendency of medical dependency; and fantasy or distortion of the actual experience, especially self-image. Moreover, the patients showed a low ability to objectively express or attribute meaning to pain due to poor language skills, attention-deficit hyperactivity disorder, and emotional value judgment. Individuals with the aforementioned characteristics of pre-CBT psychological tests should select a different treatment approach given the high poor-adaption possibility. Even patients with depressive or anxious symptoms are not necessarily adaptable for CBT. Therefore, pre-CBT tests for treatment suitability are necessary. Future studies should establish a protocol for psychotherapy suitable for the non-adaptation group. Nature Publishing Group UK 2021-04-15 /pmc/articles/PMC8050286/ /pubmed/33859240 http://dx.doi.org/10.1038/s41598-021-87239-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Shimizu, Keisuke Inage, Kazuhide Orita, Sumihisa Eguchi, Yawara Shiga, Yasuhiro Koda, Masao Aoki, Yasuchika Kotani, Toshiaki Akazawa, Tsutomu Furuya, Takeo Nakamura, Junichi Takahashi, Hiroshi Suzuki-Narita, Miyako Maki, Satoshi Hagiwara, Shigeo Inoue, Masahiro Norimoto, Masaki Kinoshita, Hideyuki Sato, Takashi Sato, Masashi Enomoto, Keigo Takaoka, Hiromitsu Mizuki, Norichika Hozumi, Takashi Tsuchiya, Ryuto Kim, Geundong Otagiri, Takuma Mukaihata, Tomohito Hishiya, Takahisa Ohtori, Seiji Background factors for chronic low back pain resistant to cognitive behavioral therapy |
title | Background factors for chronic low back pain resistant to cognitive behavioral therapy |
title_full | Background factors for chronic low back pain resistant to cognitive behavioral therapy |
title_fullStr | Background factors for chronic low back pain resistant to cognitive behavioral therapy |
title_full_unstemmed | Background factors for chronic low back pain resistant to cognitive behavioral therapy |
title_short | Background factors for chronic low back pain resistant to cognitive behavioral therapy |
title_sort | background factors for chronic low back pain resistant to cognitive behavioral therapy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050286/ https://www.ncbi.nlm.nih.gov/pubmed/33859240 http://dx.doi.org/10.1038/s41598-021-87239-2 |
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