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Integrating Psychological Science into Chronic Pain Management: Emerging Approaches and Insights

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (20 August 2026) | Viewed by 4279

Editors

Dr. Scott G. Ravyts

E-Mail Website
Guest Editor
Department of Psychology, The University of North Carolina at Charlotte, Charlotte, NC, USA
Interests: psychosocial interventions for chronic pain; insomnia and chronic pain; trauma and chronic pain
Dr. Margot De Kooning

E-Mail Website
Guest Editor
1. Faculty of Mechatronics and Medical Engineering, University of Applied Sciences Ulm, Germany
2. Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
Interests: physiotherapy; chronic pain; rehabilitation; pain assessment

Special Issue Information

Dear Colleagues,

Chronic pain is one of the leading causes of disability worldwide and is often associated with significant physical, psychological, and social consequences. While chronic pain has long been recognized as having biopsychosocial components, our understanding of how psychological factors contribute to its onset and maintenance has continued to evolve in recent years. In line with this advancement, new psychosocial interventions for chronic pain are beginning to emerge and appear to yield promising results, not only for reducing emotional distress but also pain severity and intensity among sufferers of this condition.

This Special Issue will highlight advances in our understanding of the role of psychological factors in the onset and development of chronic pain, underscoring recent innovations in psychosocial interventions.

We encourage the submission of original research and review articles on the following topics:

  • Psychosocial risk factors for the development of chronic pain;
  • The role of psychosocial factors in perpetuating chronic pain symptoms;
  • Advances in the psychosocial assessment of chronic pain;
  • Recent innovations in psychosocial interventions for chronic pain.

Dr. Scott G. Ravyts
Dr. Margot De Kooning
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic primary pain
  • nociplastic pain
  • coping strategies
  • depression
  • anxiety
  • trauma

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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10 pages, 198 KB  
Article
Effects of Cognitive Behavioral Treatment-Based Withdrawal Intervention in Patients with Long-Term Opioid Use for Chronic Pain
by C. Paul van Wilgen
J. Clin. Med. 2025, 14(21), 7640; https://doi.org/10.3390/jcm14217640 - 28 Oct 2025
Viewed by 1244
Abstract
Objectives: Prolonged opioid use leads to tolerance and hyperalgesia in patients with chronic pain. Apart from an increase in pain, opioid use also leads to several other adverse effects. Nevertheless, the prevalence of opioid use as a treatment for chronic pain remains [...] Read more.
Objectives: Prolonged opioid use leads to tolerance and hyperalgesia in patients with chronic pain. Apart from an increase in pain, opioid use also leads to several other adverse effects. Nevertheless, the prevalence of opioid use as a treatment for chronic pain remains high, and opioid withdrawal interventions deserve more attention. This study evaluates the effects of a guideline for an opioid withdrawal intervention method that is nested in cognitive behavioral treatment (CBT) and is specifically for patients with a history of long-term opioid use and chronic pain. Methods: We conducted a clinical, exploratory, and mixed-methods study involving pre- and post-measurements on opioid use and health-related quality of life (SF-36), as well as a qualitative analysis of patient experiences (interviews) to evaluate the program. Results: A total of 29 patients were included in the study; 23 of these patients no longer used opioids, and some continued withdrawal under the guidance of their general practitioner. Quality of life improved in all domains, including the amount of pain experienced. No patients reported increased pain levels, and most experienced significantly fewer adverse side effects. Patient satisfaction was high, with no negative long-term side effects of the intervention reported. Conclusions: In light of the results of this study, it is important to address opioid use in patients with chronic pain. There are strong arguments in favor of motivating patients to withdraw from using opioids to treat chronic pain, which can be achieved in combination with CBT. Full article
(This article belongs to the Special Issue Integrating Psychological Science into Chronic Pain Management: Emerging Approaches and Insights)
21 pages, 1193 KB  
Article
Planning and Problem-Solving Impairments in Fibromyalgia: The Predictive Role of Updating, Inhibition, and Mental Flexibility
by Marisa Fernández-Sánchez, Pilar Martín-Plasencia, Roberto Fernandes-Magalhaes, Paloma Barjola, Ana Belén del Pino, David Martínez-Íñigo, Irene Peláez and Francisco Mercado
J. Clin. Med. 2025, 14(15), 5263; https://doi.org/10.3390/jcm14155263 - 25 Jul 2025
Cited by 1 | Viewed by 1594
Abstract
Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been [...] Read more.
Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been addressed yet in this population. This research aimed to firstly explore how low-level EFs play a role in planning and problem-solving performances. Methods: Thirty FMS patients and thirty healthy participants completed a series of neuropsychological tests evaluating low- and high-order EFs. Clinical and emotional symptoms were assessed with self-report questionnaires, while pain and fatigue levels were measured with numerical scales. Importantly, specific drug restrictions were accounted for. Results: Patients scored lower in most neurocognitive tests, with statistical significance noted only for visuospatial working memory (WM) and two planning and problem-solving tests. Pain, fatigue, and sleep disturbances showed important effects on most of the cognitive outcomes. Multiple regression analyses reflected that planning and problem-solving were successfully and partially predicted by updating, inhibition, and mental flexibility (though differences emerged between tasks). Conclusions: Our study confirms the presence of cognitive impairments in FMS, especially in high-order EFs, supporting patients’ complaints. Clinical symptoms play a role in FMS dyscognition but do not explain it completely. For the first time, as far as the authors know, simple EF influences on planning and problem-solving tests have been described for FMS patients. These results might help in unraveling the dysexecutive profile in FMS to design more adjusted treatment options. Full article
(This article belongs to the Special Issue Integrating Psychological Science into Chronic Pain Management: Emerging Approaches and Insights)
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37 pages, 4518 KB  
Systematic Review
Mediators of the Pain–Depression Relationship in Adults with Chronic Pain: A Systematic Review and Exploratory Meta-Analyses
by Michael Tenti, Stefania Proietti, Corrado Fagnani, Emanuela Medda, Letizia Sampaolo, Laura Camoni, Federica Cilenti, Giorgia Varallo, Valentina Malafoglia, William Raffaeli and Virgilia Toccaceli
J. Clin. Med. 2026, 15(15), 5784; https://doi.org/10.3390/jcm15155784 - 23 Jul 2026
Viewed by 587
Abstract
Background/Objectives: Pain intensity and depressive symptoms are closely associated in adults with chronic pain (CP), contributing to greater disability, poorer treatment outcomes, and increased healthcare costs. However, the mechanisms underlying this symptom-level relationship remain incompletely understood. This systematic review and meta-analysis aimed [...] Read more.
Background/Objectives: Pain intensity and depressive symptoms are closely associated in adults with chronic pain (CP), contributing to greater disability, poorer treatment outcomes, and increased healthcare costs. However, the mechanisms underlying this symptom-level relationship remain incompletely understood. This systematic review and meta-analysis aimed to (i) identify all candidate factors mediating the effect of pain intensity on depressive symptoms, or vice versa, in adults with CP and (ii) estimate the magnitude of indirect, direct and total effects reported across eligible studies. Methods: Seven databases were searched in May–July 2023 and updated in May–June 2024. Observational studies and randomized controlled trials evaluating mediators of the relationship between pain intensity and depressive symptoms, or vice versa, in adults with CP were eligible. Data extraction and methodological appraisal were performed independently by three reviewers. Findings were synthesized narratively using vote counting and displayed using harvest plots. When appropriate, meta-analyses were conducted using regression coefficients, standard errors and sample sizes to estimate pooled indirect, direct and total effects. Results: The search identified 6826 studies, of which 34 (47 mediation models) met the inclusion criteria. Twenty-nine studies (combined n = 13,587) examined the effect of pain intensity on depressive symptoms, identifying 24 candidate mediators. Exploratory meta-analyses were feasible only for pain catastrophizing (indirect effect [IE]: β = 0.150; 95% confidence interval [CI]: 0.066, 0.233) and helplessness (IE: β = 0.101; CI: 0.066, 0.137). The pooled estimate for pain catastrophizing showed substantial heterogeneity and was highly influenced by a single study. Sleep quality, pain self-efficacy and pain interference showed preliminary evidence of mediation in narrative synthesis. Nine studies (combined n = 1359) investigated the effect of depressive symptoms on pain intensity, identifying 12 candidate mediators. Pain catastrophizing was the most consistently supported mediator, although quantitative synthesis was not feasible. Conclusions: Several potentially modifiable mediators of the pain–depression relationship were identified and may represent targets for multidisciplinary interventions. However, quantitative findings remain preliminary because of the limited number of studies, substantial heterogeneity for some mediators, and the predominance of cross-sectional evidence. Robust three-wave longitudinal mediation studies with adequate statistical power, standardized measures and reporting, and theory-driven models are needed to establish the temporal validity of candidate mediators and strengthen causal inferences. Full article
(This article belongs to the Special Issue Integrating Psychological Science into Chronic Pain Management: Emerging Approaches and Insights)
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