Personal Danger Signals Reprocessing: New Online Group Intervention for Chronic Pain

Chronic pain represents a formidable global health issue, affecting a considerable segment ofthe population. Even with advancements in medical interventions, a notable number ofpatients persistently suffer from pain in the absence of identifiable organic causes, designatingthis category of chronic pain as nociplastic pain. In recent years, there has been growingrecognition of the significant role that danger signal processing plays in the development andmaintenance of chronic pain. In response to this need, an innovative online group-basedtherapeutic approach was developed. The approach targets the mental mechanisms associatedwith danger signal processing, using coaching to incorporate therapeutic instruments andreaching a wider audience with an affordable and accessible online group format.This study aims to investigate the efficacy of online group intervention, termed Personal DangerSignals Reprocessing (PDSR), as a means to alleviate chronic pain and mental healthcomorbidities.A cohort of women (N=19, mean age 43) participated in an 8-week online program, receivingweekly sessions. The program encompassed a comprehensive understanding of chronic painwithin a systemic framework of PDSR. We collected pain outcomes, mental healthcomorbidities, and potential psychological mechanisms at three-time points: before, in themiddle, and after completing the intervention for a group of 19 participants, while the waitinglist group (N=20, mean age 43.5) only completed the self-report assessments on the sametimeframe. Finally, we also collected pain levels of the PDSR group 6 months after the formalintervention termination.The PDSR group experienced significant reductions in pain levels throughout the intervention (p< .001). Notably, pain levels in the PDSR group were robustly reduced both at the middle(Cohen's D = 0.7) and end (Cohen's D = 1.5) of the intervention compared to the waiting listgroup. Similarly, pain interference showed significant reductions (p < .01), with a substantialdecrease observed in the PDSR group compared to the waiting list group after the intervention(Cohen's D = -1.7, p < .0001). Well-being also significantly improved for the PDSR group at boththe middle (p < .001, Cohen's D = 1.7) and end (p < .001, Cohen's D = 1.8) of the intervention.Secondary outcomes, including pain catastrophizing, sleep interference, anxiety levels, anddepressive symptoms, all showed consistent reductions for the PDSR group compared to thewaiting list group (all p-values < .01).Findings reveal that the PDSR online intervention holds the potential to significantly reducepain, enhance functional capabilities, and elevate subjective well-being for individuals grapplingwith chronic pain. The study underscores the effectiveness of online interventions whileemphasizing the need for further research to optimize implementation strategies.