Acceptance and commitment therapy (ACT) for patients with degenerative spinal disorders and maladaptive psychological processes: an observational study
Bibliographic record
Abstract
Background: Patients living with chronic pain may experience maladaptive psychological processes that include depression, somatization, kinesiophobia, pain catastrophizing, and anxiety. Spine surgery in the setting of maladaptive psychological processes can lead to poor outcomes, but intervention with acceptance and commitment therapy (ACT), which is a specific form of cognitive-behavioral therapy (CBT), may provide benefits. Our objective was to evaluate the preliminary effectiveness of ACT for patients with degenerative spinal disorders awaiting surgery. Methods: We performed a retrospective observational study of data that were collected at a single academic center. Patient reported outcome measures (PROMs) were collected before and after ACT, while awaiting spine surgery: Patient Health Questionnaire 9 item (PHQ-9) for depression, Patient Health Questionnaire 15 item (PHQ-15) for somatization, Tampa Scale for Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS), Generalized Anxiety Disorder 7 Item Scale (GAD-7), Post-Traumatic Stress Disorder (PTSD) Checklist, Injustice Experience Questionnaire (IEQ), and Pain Disability Index (PDI). Results: Among the 63 patients, ACT was associated with significant improvements for depression [mean change -3.3, standard deviation (SD) 6.5, P<0.001], somatization (mean change -2.9, SD 4.1, P<0.001), kinesiophobia (mean change -6.1, SD 10.8, P<0.001), catastrophizing (mean change -9.9, SD 14.8, P<0.001), anxiety (mean change -2.1, SD 6.2, P=0.007), injustice (mean change -5.5, SD 8.5, P<0.001), and pain disability (mean change -6.4, SD 17.4, P<0.001), but not PTSD (mean change -3.5, SD 14.3, P=0.06). Conclusions: ACT prior to spine surgery may be associated with significant improvements for many maladaptive psychological processes. These results suggest that implementation of ACT in clinical practice could be appropriate and that further research to understand effects on outcomes after surgery is warranted.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".