Matchmaking in pain practice
Challenges and possibilitiesav
Sofia Bergbom
Akademisk avhandling
Avhandling för filosofie doktorsexamen i psykologi, som kommer att försvaras offentligt
fredag den 28 mars 2014 kl. 10.15, Hörsal L3, Örebro universitet Opponent: Docent William S. Shaw
Liberty Mutual Research Institute, Center for Disability Research
Boston, USA
Örebro universitet
Institutionen för juridik, psykologi och socialt arbete 701 82 ÖREBRO
Abstract
Sofia Bergbom (2014): Matchmaking in pain practice. Challenges and possibilities. Örebro Studies in Psychology 29.
All people experience pain and for some people, acute pain may over time develop into long-term disabling problems. Already at an early stage, it is possible to identify people at risk for long-term problems and psychologically oriented interventions have been shown to successfully prevent future disability. However, not all people are helped by treat-ment and there is room for improvetreat-ment. Moreover, subgroups of peo-ple suffering from pain, with different profiles of psychological factors have been identified, indicating that people with pain problems differ. The first aim of this dissertation was to improve the understanding of how people differ. The second aim was to use these individual differ-ences and to match people to psychological treatment based on their psychological profile. The third aim was to explore what happens during treatment that might be important for treatment outcome.
The findings show that people who belonged to subgroups with ele-vated levels of psychological factors had less favorable outcomes over time, despite treatment, than people with no elevations. Moreover, peo-ple with elevations in several psychological factors had even less favora-ble outcomes. Psychological treatments aimed at preventing future disa-bility performed well, but using profiles to match people to treatment did not improve outcomes further; people who were matched to a treat-ment and people who were unmatched had similar outcomes. However, the profiles used for matching were unstable over time and there is need to improve the identification of psychological variables used for treat-ment matching. Finally, a number of psychological factors were shown to be valuable targets for treatment; if the treatments successfully pro-duced change in people’s thoughts and emotions related to pain the treatment outcomes were better. The findings were summarized in a flow chart showing the recommended clinical approach to people seek-ing health care for acute pain problems.
Keywords: pain, psychological profiles; psychological treatment; early intervention; secondary prevention; treatment matching.
Sofia Bergbom, School of Law, Psychology and Social Work
