Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, MBA, PhD, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not cognitive behavioral therapy effectively decreases the severity of chronic pain in patients with motor vehicle accident (MVA) associated post traumatic stress disorder (PTSD).
STUDY DESIGN: Systematic review of two randomized, controlled clinical trials published in 2009 and 2012, respectively, and one primary research case study published in 2003.
DATA SOURCES: Three published studies comparing patient reported reduction in pain severity following treatment with cognitive behavioral therapy (CBT) were found using PubMed.
OUTCOMES MEASURED: The extent of pain reduction experienced by the patient after receiving treatment. Recording methods included the Pain Severity subscale of the Multidimensional Pain Inventory (PS-MPI) and Numerical Rating Scales (NRSs).
RESULTS: Beck et al3 reported a significant time effect (F = 7.61, p = .01), indicating that both the treatment group (GCBT) as well as the control group (MCC) showed a significant reduction in pain severity from pre-assessment to post-assessment. Dunne et al4 concluded that there was no significant change in pain intensity in either group over time or between the treatment (TF-CBT) and control (waitlist) groups. It should be noted that there was an increase in pain severity within the waitlist group from pre- and post-treatment assessment, although this was also determined not to be significant. The case study produced by Shipherd et al5 also reported a decrease in pain severity among their six patients, however there was no mention of the significance of this change.
CONCLUSIONS: The data to suggest that cognitive behavioral therapy effectively decreases the severity of chronic pain in patients with motor vehicle accident (MVA) associated post traumatic stress disorder (PTSD) is inconclusive. Future studies should aim to report data in a dichotomous fashion so to provide more statistically sound evidence.
Gibbs, ReAnna, "Does Cognitive Behavioral Therapy Effectively Decrease the Severity of Chronic Pain in Patients With Motor Vehicle Accident (MVA) Associated Post Traumatic Stress Disorder (PTSD)?" (2015). PCOM Physician Assistant Studies Student Scholarship. 223.