Abstract

This study compared the effectiveness of an online Behavioral Activation (BA) program that included informational support messages for individuals with Complex Regional Pain Syndrome (CRPS), focusing on the impact of social comparison content. Four participants with CRPS were randomly assigned to either an experimental group (which received informational support plus social comparison content) or a control group (which received informational support only). An eight-session online BA intervention was conducted using a multiple-baseline design. All participants monitored their daily activities, and during the intervention phase, informational support messages were sent immediately after each submission. The experimental group also received social comparison information regarding other participants. Outcomes were evaluated at pre-, post-, and follow-up stages, measuring pain intensity, pain interference, pain catastrophizing, depressive symptoms, life satisfaction, and activity patterns. Effect sizes (Cohen’s d) were calculated. Both groups experienced increases in goal-directed activity. In the experimental group, pain intensity fluctuated, while it generally increased in the control group. Depression levels rose in the experimental group but fell in the control group. At follow-up, the experimental group exhibited at least small effects on all variables except for pain intensity, pain interference, pain-contingent persistence, and pacing for the purpose of increasing activity level and reducing pain. The control group also showed at least small effects, except for pain intensity, pain-contingent persistence, and pacing strategies aimed at conserving energy for valued activities and reducing pain. These findings suggest that an online BA program enhanced with informational support may benefit individuals with CRPS, although the inclusion of social comparison information appeared to have limited additional effects.