Is Past Adjustment of Unhelpful Thinking Associated with Greater Cognitive Flexibility Among People Seeking Musculoskeletal Specialty Care?

Background: Unhelpful thoughts are associated with greater levels of pain intensity and incapability. Difficulty cultivating a healthier inner narrative regarding sensations is associated with lower tolerance of uncertainty and lower cognitive flexibility. Among people seeking musculoskeletal specialty care we analyzed associations between mindset factors and awareness of prior experiences adjusting unhelpful thinking and trust in the clinician.

Methods: In a cross-sectional study, 163 adults completed measures of mindsets (intolerance of uncertainty, cognitive flexibility, and distress and unhelpful thoughts regarding sensations), awareness of prior experiences adjusting unhelpful thinking, and trust and experiences with clinicians. We measured associations between mindsets (both individually and in statistical clusters) awareness of prior experiences and trust in the clinician.

Results: Both awareness of prior experiences adjusting thinking and trust in the clinician were modestly associated with greater cognitive flexibility in bivariate analysis, but neither were associated with statistical groupings with healthier mindsets identified in cluster analysis.

Conclusion: The modest associations with cognitive flexibility suggest that both the inability to describe a past experience rethinking one's interpretation of bodily sensations, as well as difficulty establishing trust with the clinician, might signal unhealthy fusion with unhelpful thoughts that are known correlates of greater levels of discomfort and incapability.