Document Detail


Brief cognitive-behavioral therapy for temporomandibular disorder pain: effects on daily electronic outcome and process measures.
MedLine Citation:
PMID:  16153777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We used patient daily electronic ratings of outcome (activity interference, pain intensity, jaw use limitations, negative mood) and process (pain-related beliefs, catastrophizing, and coping) variables to evaluate a brief cognitive-behavioral (CB) treatment for chronic temporomandibular disorder (TMD) pain. TMD clinic patients (N=158) were assigned randomly to four biweekly sessions of either CB pain management training (PMT) or an education/attention control condition [self-care management (SCM)] and were asked to complete electronic interviews three times daily for the 8-week treatment. We analyzed diary data from 126 participants who completed >50% of requested interviews for >6 weeks. Multilevel regression analyses indicated no statistically significant difference between the study groups in rate of within-subject change over time on the daily outcome measures, but consistently greater within-subject improvement in the PMT group on the daily process measures. Significantly (P<0.05) greater proportions of PMT than of SCM patients showed clinically important (>50%) improvement from weeks 1 to 8 in daily activity interference and jaw use limitations. This study is novel in its application of electronic diary methods for assessing outcome and process variables in a chronic pain treatment trial, and supports the feasibility and utility of such methods. The brief CB treatment was efficacious in decreasing catastrophizing and increasing perceived control over pain, and in improving activity interference and jaw use limitations for a subgroup of patients. Longer-term follow-ups are ongoing to determine if there is an impact on outcomes over time.
Authors:
Judith A Turner; Lloyd Mancl; Leslie A Aaron
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pain     Volume:  117     ISSN:  0304-3959     ISO Abbreviation:  Pain     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-03     Completed Date:  2006-01-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  377-87     Citation Subset:  IM    
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Box 356560, Seattle, WA 98195, USA. jturner@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Adult
Automatic Data Processing / methods
Case-Control Studies
Cognitive Therapy / methods*
Female
Humans
Interviews as Topic / methods
Male
Middle Aged
Pain / etiology,  therapy*
Pain Measurement / methods
Regression Analysis
Temporomandibular Joint Disorders / complications,  therapy*
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01 DE08773/DE/NIDCR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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