Effectiveness of psychological interventions to decrease cognitive fusion in patients with chronic pain: A systematic...

Area of Science:

• Psychology
• Clinical Psychology
• Pain Management

Background:

• Acceptance and Commitment Therapy (ACT) is effective for chronic pain.
• Cognitive fusion, a core component of ACT, needs further investigation.
• The impact of psychological interventions on cognitive fusion in chronic pain is not well-established.

Purpose of the Study:

• To assess the effectiveness of psychological interventions in reducing cognitive fusion among chronic pain patients.
• To synthesize existing evidence on the impact of psychological therapies on cognitive fusion.

Main Methods:

• A systematic review of studies was conducted using major databases (Web of Science, SCOPUS, Medline, PsycINFO) up to June 2024.
• Studies included chronic pain patients undergoing psychological interventions with a cognitive fusion measure.
• Methodological quality was assessed, and effect sizes (Hedges g) were calculated.

Main Results:

• 18 articles comprising 24 studies were included (19 pre-post/follow-up, 5 RCTs).
• Cognitive fusion significantly decreased post-intervention (small/medium effect sizes: g = -0.39 at post-test, g = -0.55 at long-term follow-up).
• Similar significant reductions were observed in RCTs across follow-up periods, with medium effect sizes.

Conclusions:

• Psychological interventions demonstrate a tendency to decrease cognitive fusion in individuals with chronic pain.
• More clinical trials are required to definitively establish the role of cognitive fusion within the broader framework of psychological flexibility.
• Identified moderator variables include unemployment, gender, pain intensity, depression levels, and intervention characteristics.