Presented at the 2012 AAPM Annual Meeting « Back

Improvements in Alexithymia After Participation in an Interdisciplinary Chronic Pain Program: We Can Treat It, but Does It Matter?

Sara A. Davin, PsyD MPH, sara.a.davin@gmail.com¹, Jacqueline Olthoff, PsyD¹, Judith Scheman, PhD¹, Edward Covington, MD¹, (1) Cleveland Clinic Neurological Center for Pain, Cleveland, Ohio

Persistent, disabling chronic pain can be difficult to treat, and is often not responsive to single modality treatments. Psychosocial variables have been shown to be better predictors of chronic pain than the extent of the original pathology. Previous research demonstrates that patients with chronic pain display higher rates of alexithymia, than the general population. Additionally, alexithymia is predictive of poor functioning and is thought to be a stable trait changing only as related to depression. However, there are no investigations of whether alexithymia changes after participating in an interdisciplinary chronic pain rehabilitation program (CPRP). Utilizing an IRB approved data registry, 40 participants in Cleveland Clinic’s CPRP from January to August 2011, were assessed for changes in pain, mood and function after the ~3 week program that included physical therapy, occupational therapy, psychological treatments, as well as medication management with weaning from all addictive substances. Patients completed the Pain VAS, Pain Disability Index, Depression Anxiety Stress Scale and Toronto Alexithymia Scale (TAS). All patients showed normalization of scores on the TAS. Paired t-tests and correlational analyses were used to examine changes in alexithymia, pain, depression and function. Significant improvements in alexithymia after the program were unrelated to mood, function or pain. While improvements in pain, mood and function were all correlated with one another, they were independent of improvements in alexithymia. Results demonstrate compellingly that alexithymia is not a fixed trait, but changes with treatment. They do not confirm that correcting alexithymia correlates with reduced somatic distress and impairment. References: 1)Millard, R.W. & Kinsler, B.L. (1992). Evaluation of constricted affect in chronic pain: an attempt using the Toronto Alexythymia Scale. Pain, 50, 287-292. 2)Lumley, M.A., Smith, J.A. & Longo, D.J. (2002). The relationship of alexithymia to pain severity and impairment among patients with chronic myofascial pain: comparisons with self-efficacy, catastrophizing and depression. Journal of Psychosomatic Research, 3)Luminet, O., Bagby, M. & Taylor, G.J. (2001). An evaluation of the absolute and relative stability of alexithymia in patients with major depression. Psychotherapy and Psychsomatics, 70, 254-260. 4)Tait, R. C., Pollard, C.A., Margolis, R. B, Duckro, P.N., Krause, S. J. (1987). The Pain Disability Index: psychometric and validity data. Archives of Physical Medicine and Rehabilitation, 68(7), 438-441. PMID: 3606368 5)Lovibond, S. H. and Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed,). Sydney, Australia: Psychology Foundation of Australia. 6)Taylor, G.J., Bagby, R.M., and Parker, J.D.A., (2003). Toronto Alexithymia Scale, Journal of Psychosomatic Research, 55, 269-275.

Funding: None