Abstract
Pain experiences are often complex with catastrophic cognitions, emotions, and behaviors. Cognitive behavioral therapists share the work of unraveling these complex experiences with their patients. However, the change process underlying the unraveling of the pain experience have not yet been quantified. We used an interrelationship-focused network model to examine the way an undifferentiated conceptualization between cognition and pain experience changed via group cognitive-behavioral therapy (CBT). Overall, 65 participants were included in the study; they attended the total of 12 weekly group CBT and filled the Short-Form McGill Pain Questionnaire and the pain catastrophizing questionnaire. Before treatment, there were no edges in the partial correlation-based network because of large covariation across items. After treatment, many edges appeared and, particularly strong couplings were found between items within the same subscale. The formative shift from a non-edged pre-treatment network to a mature post-treatment network indicates that patients were able to conceptualize these symbolic constructs better. These results are consistent with the fundamental monitoring process of CBT.