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ONLINE ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN IN A SAMPLE OF PEOPLE WITH CHIARI MALFORMATION: A PILOT STUDY

Garcia , Monica
http://rave.ohiolink.edu/etdc/view?acc_num=kent1623253740543813

Abstract Details

2021, PHD, Kent State University, College of Arts and Sciences / Department of Psychological Sciences.
Objective. Chronic pain is a complex disorder often presenting with comorbid anxiety, depression, and sleep dysfunction, each of which perpetuates pain-related symptomatology. Acceptance and Commitment Therapy (ACT), an intervention based on increasing engagement in valued activities and decreasing experiential avoidance, is an empirically-supported treatment for chronic pain. However, face-to-face interventions are costly and require trained clinicians to administer. In an attempt to increase the accessibility of effective treatments, research has begun to explore the efficacy of online ACT interventions for chronic pain with positive results. Given the complex combinations of disorders that often present with chronic pain an intervention that broadly teaches ACT philosophies without focusing only on pain may facilitate the generalization of skills to comorbid conditions and provide more comprehensive treatment. The present study administered a broad online ACT intervention that is able to flexibly address participants’ changing symptom presentations and aimed to examine the efficacy of this intervention. Method. 53 adults (ages 18-65) with Chiari Malformation (CM), a disorder characterized by chronic pain, were randomized into either the treatment or control group. Both groups completed baseline assessments followed by 8 weekly assessments of pain interference, anxiety, depression, sleep dysfunction, chronic pain acceptance, and psychological flexibility; the treatment group also completed 8 weekly online intervention modules. All participants also completed an assessment immediately following the intervention and at 1-month post intervention. Multi-level modeling utilized all assessment time-points to examine group differences in symptom trajectories between baseline and 1-month follow-up. Results. Significant group differences were identified in the trajectories of sleep dysfunction, psychological flexibility, and chronic pain acceptance (including both the activity engagement and pain willingness subscales). However, there were no significant group differences in pain interference or depression and a group by time interaction predicting anxiety symptoms was only trending towards significance. Psychological flexibility was a significant predictor of sleep dysfunction, but it did not serve as a mediator of sleep dysfunction over time. Conclusion. The current study provides preliminary evidence supporting the use of this online intervention to teach ACT philosophies. The treatment group exhibited significant improvement in psychological flexibility, chronic pain acceptance, pain willingness, and activity engagement. The impacts on sleep dysfunction (significant group differences identified, but a large percentage remained above the cutoff for moderate insomnia), anxiety, depression, and pain interference were as not noteworthy. This indicates that some alterations may be needed in the intervention to effectively target these symptoms.
Douglas Delahanty (Committee Chair)
John Gunstad (Committee Member)
Jeffrey Ciesla (Committee Member)
Wendy Umberger (Committee Member)
Richard Adams (Committee Member)
115 p.
Clinical Psychology
Online Intervention; ACT; chronic pain; Chiari Malformation

Recommended Citations

Citations

  • Garcia , M. (2021). ONLINE ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN IN A SAMPLE OF PEOPLE WITH CHIARI MALFORMATION: A PILOT STUDY [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent1623253740543813

    APA Style (7th edition)

  • Garcia , Monica . ONLINE ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN IN A SAMPLE OF PEOPLE WITH CHIARI MALFORMATION: A PILOT STUDY. 2021. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent1623253740543813.

    MLA Style (8th edition)

  • Garcia , Monica . "ONLINE ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN IN A SAMPLE OF PEOPLE WITH CHIARI MALFORMATION: A PILOT STUDY." Doctoral dissertation, Kent State University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1623253740543813

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Kent State University and OhioLINK.