Comparing the Effectiveness of Cognitive-behavioral Therapy and Dialectical Behavior Therapy on the Pain Metaphorical Perception in Patients with Chronic Pain

Document Type : Original Research

Authors
R. Rahimi 1
S. Abddoust sardehaei 1
A. Lashgari 2
H. Darbandi 3
1 Islamic Azad University- South Tehran Branch, Faculty of Psychology and Educational Sciences
2 Islamic Azad University-Rodehen branch
3 Islamic Azad University, electronic-Campus. Tehran, Iran
10.22034/IJMPP.9.4.1133
Abstract
Aims: This study was conducted to compare the effectiveness of cognitive-behavioral therapy and dialectical behavior therapy on the pain metaphorical perception in patients with chronic pain.

Method and Materials: The study method was semi-experimental with a pre-test-post-test design and control group. The population was all people with chronic pain in the first six months of 2024 in Tehran. Accordingly, 45 patients with chronic pain were selected voluntarily and randomly assigned to intervention and control groups (each group n=15). The Questionnaire of the study was Raiisi`s Pain Metaphorical Perception. The first experimental group received eight sessions of 90-minute cognitive-behavioral therapy, but the second group received eight sessions of 90-minute dialectical behavior therapy. The control group did not receive any intervention. The data were analyzed using multivariate analysis of covariance by SPSS-26.

Findings: The results indicated that cognitive-behavioral therapy and dialectical behavior therapy significantly increased components of pain metaphorical perception (object, force, human, and causality) in patients with chronic pain (P<0.001).

Conclusion: The findings of this research emphasized the effectiveness of cognitivebehavioral therapy and dialectical behavior therapy on the pain metaphorical perception. As a result, by changing the metaphors of pain in patients, the interpretation of pain can be changed.

Keywords

Subjects

1. Knowles CH, Cohen RC. Chronic anal pain: A review of causes, diagnosis, and treatment. Cleve Clin J Med, 2022;89(6):336-343. doi: 10.3949/ccjm.89a.21102.
2. Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth, 2019;123(2):e273-e283. doi:10.1016/j.bja.2019.03.023.
3. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on the burden, best practices, and new advances. Lancet, 2021;397(10289):2082-2097. doi:10.1016/S0140-6736(21)00393-7.
4. Tehranizadeh M, Raiisi F. The Relationships between Depression, Self-Efficacy, Physical Disability and Chronic Pain. IJMPP 2020; 5(3):373-379. Doi:10.52547/ijmpp.5.3.373.
5. Goudman L, Vets N, Jansen J, De Smedt A, Moens M. The Association Between Bodily Functions and Cognitive/Emotional Factors in Patients with Chronic Pain Treated with Neuromodulation: A Systematic Review and Meta-Analyses. Neuromodulation, 2023;26(1):3-24. doi:10.1016/j.neurom.2021.11.001.
6. Kövecses K. Metaphor universals in literature. Argumentum, 2019,15:264-76. Doi:10.18226/19844921.v10.n20.10
7. Lakoff G. The contemporary theory of metaphor. In A. Ortony (Ed.), Metaphor and thought (PP.202–251). United Kingdom, Cambridge University Press. 1993. https://doi.org/10.1017/CBO9781139173865.013.
8. Kövecses Z. Meaning Making, Where Metaphors Come From: Reconsidering Context in Metaphor. United Kingdom, Oxford Academic Press. 2015. https://doi.org/10.1093/acprof:oso/9780190224868.003.0002
9. Kövecses Z. Extended Conceptual Metaphor Theory. Cambridge: Cambridge University Press. 2020. https://doi.org/10.1080/10926488.2020.1813035.
10. Raiisi F, Afrashi A, Moghadasin M, HajiKaram A, Nematzadeh S. Understanding of metaphorical time pattern among medical and paramedical students. Based on gender, age, and academic status. SJKU, 2019;24(4):56-67. Doi:10.29252/sjku.24.4.56.
11. Raiisi F. Pain Metaphors as a Bridge between Physician and Patient: An Interdisciplinary Approach. IJMPP, 2023;8(2):862-863. Doi: 10.22034/ijmpp.8.2.862.
12. de Kleine RA, Smits JAJ, Hofmann SG. Advancements in Cognitive Behavioral Therapy. Psychiatr Clin North Am, 2024;47(2):xiii-xv. Doi: 10.1016/j.psc.2024.03.001.
13. Lackner JM, Clemens JQ, Radziwon C, Danforth TL, Ablove TS, Krasner SS, Vargovich AM, O'Leary PC, Marotto T, Naliboff BD. Cognitive Behavioral Therapy for Chronic Pelvic Pain: What Is It and Does It Work? J Urol, 202;211(4):539-550. doi:10.1097/JU.0000000000003847.
14. Heyne D. Practitioner Review: Signposts for Enhancing Cognitive-Behavioral Therapy for School Refusal in Adolescence. Z Kinder Jugendpsychiatr Psychother, 2023;51(1):61-76. doi:10.1024/1422-4917/a000899.
15. Denecke K, Schmid N, Nüssli S. Implementation of Cognitive Behavioral Therapy in e-Mental Health Apps: Literature Review. J Med Internet Res, 2022;24(3):e27791. doi:10.2196/27791.
16. Martin S. Using values in cognitive and behavioral therapy: A bridge back to philosophy. J Eval Clin Pract, 2023;29(7):1189-1195. doi:10.1111/jep.13872.
17. Kutsuzawa K, Taguchi K, Shimizu E. Attention and Imagery in Cognitive-Behavioral Therapy for Chronic Pain: An Exploratory Study. J Psychosoc Nurs Ment Health Serv. 2022; 60(5):45-54. doi:10.3928/02793695-20211118-01.
18. Haft SL, O'Grady SM, Shaller EAL, Liu NH. Cultural adaptations of dialectical behavior therapy: A systematic review. J Consult Clin Psychol, 2022;90(10):787-801. doi:10.1037/ccp0000730.
19. Janssen A, Walkup JT. Editorial: Dialectical Behavior Therapy: More Is Not Always Better When Different Is Required. J Am Acad Child Adolesc Psychiatry, 2022;61(9):1084-1086. doi:10.1016/j.jaac.2022.05.006.
20. DeCou CR, Comtois KA, Landes SJ. Dialectical Behavior Therapy Is Effective for the Treatment of Suicidal Behavior: A Meta-Analysis. Behav Ther. 2019;50(1):60-72. doi:10.1016/j.beth.2018.03.009.
21. Norman-Nott N, Wilks CR, Hesam-Shariati N, Schroeder J, Suh J, Czerwinski M, Briggs NE, Quidé Y, McAuley J, Gustin SM. The No Worries Trial: Efficacy of Online Dialectical Behaviour Therapy Skills Training for Chronic Pain (iDBT-Pain) Using a Single Case Experimental Design. J Pain, 2022;23(4):558-576. doi:10.1016/j.jpain.2021.10.003.
22. Barrett D, Brintz CE, Zaski AM, Edlund MJ. Dialectical Pain Management: Feasibility of a Hybrid Third-Wave Cognitive Behavioral Therapy Approach for Adults Receiving Opioids for Chronic Pain. Pain Med, 2021;22(5):1080-1094. doi:10.1093/pm/pnaa361.
23. Groß J, Möller A. A Note on Cohen’s d From a Partitioned Linear Regression Model. J Stat Theory Pract, 2023;17, 22. https://doi.org/10.1007/s42519-023-00323-w.
24. Raiisi F. Designing, Making and Evaluating Psychometric Characteristics of Pain Metaphorical Perception Questionnaire in Persian-Speaking Patients with Chronic Diseases. Journal of Research in Psychological Health, 2023,17(2):1-15. [Persian] URL: http://rph.khu.ac.ir/article-1-4325-fa.html
25. Pawluk EJ, McCabe RE. Cognitive behavioral group therapy. In A. Wenzel (Ed.), Handbook of cognitive behavioral therapy: Applications (pp.479–511). American Psychological Association.2021. https://doi.org/10.1037/0000219-015.
26. Linehan MM, Korslund KE, Harned MS, et al. Dialectical Behavior Therapy for High Suicide Risk in Individuals with Borderline Personality Disorder: A Randomized Clinical Trial and Component Analysis. JAMA Psychiatry, 2015;72(5):475–482. doi:10.1001/jamapsychiatry.2014.3039.
27. Taguchi K, Numata N, Takanashi R, Takemura R, Yoshida T, Kutsuzawa K, Yoshimura K, Shimizu E. Integrated cognitive behavioral therapy for chronic pain: An open-labeled prospective single-arm trial. Medicine (Baltimore), 2021;100(6):e23859. doi:10.1097/MD.0000000000023859.
28. Pardos-Gascón EM, Narambuena L, Leal-Costa C, van-der Hofstadt-Román CJ. Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review. Int J Clin Health Psychol, 2021;21(1):100197. doi:10.1016/j.ijchp.2020.08.001.
29. Meziat-Filho N, Fernandez J, Castro J. Cognitive functional therapy for chronic disabling low back pain. Lancet. 2023; 401(10391):1828-1829. doi:10.1016/S0140-6736(23)00571-8.
30. Taguchi K, Numata N, Takanashi R, Takemura R, Yoshida T, Kutsuzawa K, Yoshimura K, Shimizu E. Integrated cognitive behavioral therapy for chronic pain: An open-labeled prospective single-arm trial. Medicine (Baltimore). 2021;100(6):e23859. doi: 10.1097/MD.0000000000023859.
31. Chapman AL. Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont). 2006;3(9):62-8. PMID: 20975829.
32. Abdolghaderi M, Narimani M, Atadokht A, Abolghasemi A, Hatamian H, Kafie M et al. The Effectiveness of Dialectical Behavior Therapy on Sleep Quality and Pain Management in Multiple Sclerosis. Caspian J Neurol Sci, 2020; 6(4):205-213. Doi:10.32598/CJNS.6.23.1.
International Journal of Musculoskeletal Pain Prevention
Volume 9, Issue 4
November 2024
Pages 1133-1140