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J. Clin. Med. 2019, 8(1), 24; https://doi.org/10.3390/jcm8010024

Baseline Psychological Inflexibility Moderates the Outcome Pain Interference in a Randomized Controlled Trial on Internet-based Acceptance and Commitment Therapy for Chronic Pain

1
Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, 3500 Krems, Austria
2
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Ulm, 89069 Ulm, Germany
3
Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
4
INPUT Pain Management Guy’s and St Thomas’ NHS Foundation Trust London, London SE1 7EH, UK
5
Department of Sports and Sport Science, University of Freiburg, 79098 Freiburg, Germany
*
Author to whom correspondence should be addressed.
Received: 5 December 2018 / Revised: 20 December 2018 / Accepted: 23 December 2018 / Published: 25 December 2018
(This article belongs to the Special Issue Psychosomatic Medicine)
Full-Text   |   PDF [617 KB, uploaded 25 December 2018]   |  

Abstract

This study re-investigated data of a randomized controlled trial on Internet-based Acceptance and Commitment Therapy for chronic pain (ACTonPain). Baseline psychological inflexibility was examined as a moderator of the outcome pain interference. In the ACTonPain trial, participants with chronic pain were randomized to one of three conditions: guided Internet-based ACT (n = 100), unguided Internet-based ACT (n = 101), and waitlist (n = 101). Moderation analyses were performed with the SPSS macro PROCESS. Pain interference according to the Multidimensional Pain Inventory (MPI) was the primary outcome in this trial, and the potential moderator psychological inflexibility was measured with the Acceptance and Action Questionnaire (AAQ-II). Psychological inflexibility at baseline moderated the outcome between guided Internet-based ACT and waitlist 9-weeks as well as 6-months after randomization. (both p < 0.05). Between unguided Internet-based ACT and waitlist, psychological inflexibility moderated the outcome 6-months after randomization (p < 0.05). Internet-based ACT was superior to waitlist for participants with less psychological inflexibility at baseline, but Internet-based ACT became increasingly comparable to waitlist at higher AAQ-II baseline values. Future research should investigate whether the results can be replicated in more individualized and tailored face-to-face settings. View Full-Text
Keywords: acceptance and commitment therapy; psychological inflexibility; chronic pain acceptance and commitment therapy; psychological inflexibility; chronic pain
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Probst, T.; Baumeister, H.; McCracken, L.M.; Lin, J. Baseline Psychological Inflexibility Moderates the Outcome Pain Interference in a Randomized Controlled Trial on Internet-based Acceptance and Commitment Therapy for Chronic Pain. J. Clin. Med. 2019, 8, 24.

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