Being Trapped and Seeing No Way Out - Effects of Entrapment on Treatment Outcome in an Interdisciplinary Pain Treatment

Background: Entrapment describes a feeling of being stuck in an inescapable aversive situation. This feeling often arises in the context of uncontrollable and/or chronic stress and is associated with various psychopathologies. Objective: Owing to the nature of their disease, also chronic pain, patients might experience their situation as unremitting and inescapable. The aim of the present study was to examine the role of entrapment in patients with a chronic pain disorder and the association of entrapment with treatment outcome. Methods: A total of 189 patients with a chronic pain disorder where psychological factors play a decisive role in its severity, exacerbation, and maintenance (International Classification of Diseases, ICD-10: F45.41, "Chronic pain disorder with somatic and psychologic factors") receiving inpatient care completed a set of standardized self-report questionnaires at intake and discharge of an interdisciplinary pain treatment. To analyze the effects of entrapment on pain-related interference and psychologic distress, hierarchical linear models were used. Results: Over treatment, reduced levels of entrapment were observed, which were associated with decreases in psychologic distress and pain-related interference at discharge. Conclusion: Results support the relevance of entrapment in chronic pain and its treatment. To further improve interdisciplinary pain treatments, entrapment should be assessed and targeted by according interventions.