Annals of Behavioral Medicine

, Volume 23, Issue 1, pp 42–49 | Cite as

Brief cognitive interventions for burn pain

  • Jennifer A. Haythornthwaite
  • John W. Lawrence
  • James A. Fauerbach


This study tested the efficacy of 2 brief cognitive interventions in supplementing regular medical treatment for pain during burn dressing change. Forty-two burn inpatients were randomly assigned to 3 groups: sensory focusing, music distraction, and usual care. Patients reported pain, pain relief, satisfaction with pain control and pain coping strategies. The sensory focusing group reported greater pain relief compared to the music distraction group and a reduction in remembered pain compared to the usual care group, although group differences were not observed on serial pain ratings. In addition, after controlling for burn size and relevant covariates, regression analyses indicated that catastrophizing predicted pain, memory for pain, and satisfaction with pain control. Refinement of the sensory focusing intervention is warranted to reduce catastrophic thinking and improve pain relief.


Behavioral Medicine Pain Rating Usual Care Group Total Body Surface Area Cognitive Intervention 
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  1. (1).
    Patterson DR, Ptacek JT: Baseline pain as a moderator of hypnotic analgesia for burn injury treatment.Journal of Clinical and Consulting Psychology. 1997,65:60–67.CrossRefGoogle Scholar
  2. (2).
    Patterson DR, Everett JJ, Burns GL, Marvin JA: Hypnosis for the treatment of burns.Journal of Consulting and Clinical Psychology. 1992,60:1–5.CrossRefGoogle Scholar
  3. (3).
    Baron RS, Logan H, Hoppe S: Emotional and sensory focus as mediators of dental pain among patients differing in desired and felt dental control.Health Psychology. 1993,12:381–389.PubMedCrossRefGoogle Scholar
  4. (4).
    Turk DC, Meichenbaum D, Genest M: Pain and Behavioral Medicine: A Cognitive—Behavioral Approach. New York: Guilford, 1983.Google Scholar
  5. (5).
    Dar R, Leventhal H: Schematic processes in pain perception.Cognitive Therapy and Research. 199317:341–356.CrossRefGoogle Scholar
  6. (6).
    Leventhal H, Brown D, Shacham S, Engquist G: Effects of preparatory informaton about sensations, threat of pain and attention on cold pressor distress.Journal of Personality and Social Psychology. 1979,37:688–714.PubMedCrossRefGoogle Scholar
  7. (7).
    Logan HL, Baron RS, Kohout F: Sensory focus as therapeutic treatments for acute pain.Psychosomatic Medicine. 1995,57:475–484.PubMedGoogle Scholar
  8. (8).
    Cioffi D: Beyond attentional strategies: A cognitive-perceptual model of somatic interpretation.Psychological Bulletin. 1991,109:25–41.PubMedCrossRefGoogle Scholar
  9. (9).
    McCaul KD, Malott JM: Distraction and coping with pain.Psychological Bulletin. 1984,95:516–533.PubMedCrossRefGoogle Scholar
  10. (10).
    Geisser ME, Robinson ME, Pickern WE: Differences in cognitive coping strategies among pain-sensitive and pain-tolerant individuals on the cold-pressor test.Behavior Therapy. 1992,23:31–41.CrossRefGoogle Scholar
  11. (11).
    Jacobsen PB, Butler RW: Relation of cognitive coping and catastrophizing to acute pain and analgesic use following breast cancer surgery.Journal of Behavioral Medicine. 1996,19:17–29.PubMedCrossRefGoogle Scholar
  12. (12).
    Buckelew SP, Conway RC, Shutty MS, et al.: Spontaneous coping strategies to manage acute pain and aniety during electrodiagnostic studies.Archives of Physical Medicine and Rehabilitation. 1992,73:594–598.PubMedGoogle Scholar
  13. (13).
    Jensen MP, Turner JA, Romano JM, Karoly P: Coping with chronic pain: A critical review of the literature.Pain. 1991,47:249–283.PubMedCrossRefGoogle Scholar
  14. (14).
    Keefe FJ, Salley AN, Lefebvre JC: Coping with pain: Conceptual concerns and future directions.Pain. 1992,51:131–134.PubMedCrossRefGoogle Scholar
  15. (15).
    Sullivan MJL, Thorn B , Haythornthwaite JA, et al.: Theoretical perspectives on the relation between catastrophizing and pain. Clinical Journal of Pain (in press, 2000).Google Scholar
  16. (16).
    Wallenstein SL: Scaling clinical pain and pain relief. In Bromm R (ed),Pain Measurement in Man: Neurophysiological Correlates of Pain. New York: Elsevier, 1984, 389–396.Google Scholar
  17. (17).
    Mackie A: Further thoughts on analgesia and pain relief. In Chapman CR, Loeser JD (eds),Issues in Pain Management. New York: Raven Press, 1989, 183–185.Google Scholar
  18. (18).
    Haythornthwaite JA, Fauerbach JA: Assessment of pain, pain relief, and patient satisfaction. In Turk DC, Melzack R (eds), Handbook of Pain Assessment. New York: Guilford, in press.Google Scholar
  19. (19).
    Stahmer SA, Shofer FS, Marino A, Shepherd S, Abbuhl S: Do quantitative changes in pain intensity correlate with pain relief and satisfaction?Academy of Emergency Medicine. 1998,5:851–857.CrossRefGoogle Scholar
  20. (20).
    Price DD:Psychological Mechanisms of Pain and Analgesia. Seattle, WA: International Association for the Study of Pain, 1999.Google Scholar
  21. (21).
    Fischer D, Stewart AL, Bloch DA, et al.: Capturing the patient’s view of change as a clinical outcome measure.Journal of the American Medical Association. 1999,282:1157–1162.PubMedCrossRefGoogle Scholar
  22. (22).
    Cioffi D, Holloway J: Delayed costs of suppressed pain.Journal of Personality and Social Psychology. 1993,64:274–282.PubMedCrossRefGoogle Scholar
  23. (23).
    Feller I, Tholen D, Cornell R: Improvements in burn care, 1965–1979.Journal of the American Medical Association. 1980,244:2074–2078.PubMedCrossRefGoogle Scholar
  24. (24).
    Rosenstiel AK, Keefe FJ: The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment.Pain. 1983,3:1–8.Google Scholar
  25. (25).
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J: An inventory for measuring depression.Archives of General Psychiatry 1961,4:561–571.PubMedGoogle Scholar
  26. (26).
    Patt RB, Szalados JE, Wu CL: Pharmacotherapeutic guidelines. In Patt RB (ed),Cancer Pain. Philadelphia: Lippincott, 1993, 565–575.Google Scholar
  27. (27).
    Gotzsche PC: Sensitivity of effect variables in rheumatoid arthritis: A meta-analysis of 130 placebo controlled NSAID trials.Journal of Clinical Epidemiology 1990,43:1313–1318.PubMedCrossRefGoogle Scholar
  28. (28).
    Gil KM, Wilson JJ, Edens JL, et al.: Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease.Health Psychology. 1996,15:3–10.PubMedCrossRefGoogle Scholar
  29. (29).
    Redelmeier DA, Kahneman D: Patients’ memories of painful medical treatments: Real-time and retrospective evaluations of two minimally invasive procedures.Pain. 1996,66:3–8.PubMedCrossRefGoogle Scholar
  30. (30).
    Sullivan MJL, Neish N: The effects of disclosure on pain during dental hygiene treatment: The moderating role of catastrophizing.Pain. 1999,79:155–163.PubMedCrossRefGoogle Scholar
  31. (31).
    Christenfeld N: Memory for pain and the delayed effects of distraction.Health Psychology 1997,16:327–330.PubMedCrossRefGoogle Scholar
  32. (32).
    Geisser ME, Robinson ME, Keefe FJ, Werner ML: Catastrophizing, Depression and the sensory affective and evaluative aspects of chronic pain.Pain. 1994,59:79–83.PubMedCrossRefGoogle Scholar
  33. (33).
    Sullivan MJL, Stanish W, Waite H, Sullivan M, Tripp DA: Catastrophizing, pain, and disability in patients with soft-tissue injuries.Pain. 1998,77:253–260.PubMedCrossRefGoogle Scholar
  34. (34).
    McCaul KD, Monson N, Maki RH: Does distraction reduce pain-produced distress among college students?Health Psychology. 1992,11:210–217.PubMedCrossRefGoogle Scholar
  35. (35).
    Suls J, Fletcher B: The relative efficacy of avoidant and nonavoidant coping strategies: A meta-analysis.Health Psychology 1985,4:249–288.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2001

Authors and Affiliations

  • Jennifer A. Haythornthwaite
    • 1
  • John W. Lawrence
    • 1
  • James A. Fauerbach
    • 1
  1. 1.Department of Psychiatry & Behavioral SciencesJohns Hopkins University School of MedicineBaltimore

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