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Remskar M, Western MJ, Ainsworth B. Mindfulness improves psychological health and supports health behaviour cognitions: Evidence from a pragmatic RCT of a digital mindfulness-based intervention. Br J Health Psychol 2024. [PMID: 39169217 DOI: 10.1111/bjhp.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
BACKGROUND Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators. METHODS Participants from 91 countries (N = 1247, Mage = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions. RESULTS Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (Mdifference = 2.34, 95%CIs .45-4.24, p = .016), lower depression (Mdifference = -1.47, 95%CIs -2.38 to -.56, p = .002) and anxiety symptoms (Mdifference = -.77, 95%CIs -1.51 to -.02, p = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being. CONCLUSIONS Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours.
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Affiliation(s)
- Masha Remskar
- Bath Centre for Mindfulness and Community, Department of Psychology, University of Bath, Bath, UK
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Max J Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Ben Ainsworth
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
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He Y, Ge L, Yuan J, Wang Y, Zheng D, Rui A, Song J, Hu L, Wei GX. Interoceptive awareness mediated the effects of a 15-minute diaphragmatic breathing on empathy for pain: A randomized controlled trial. Psychophysiology 2024; 61:e14573. [PMID: 38530127 DOI: 10.1111/psyp.14573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/28/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024]
Abstract
Although empathy for pain plays an important role in positive interpersonal relationships and encourages engagement in prosocial behavior, it remains largely unknown whether empathy for pain could be effectively altered by psychophysiological techniques. This study aimed to investigate the impact of a single session of diaphragmatic breathing practice on empathy for pain and examine the potential mechanism involving interoceptive awareness. A total of 66 healthy participants were randomly assigned to the intervention group or the control group. The intervention group received a 15-minute diaphragmatic breathing (DB) practice with real-time biofeedback, while the control group was to gaze at a black screen at rest and not engaged in any other activities. Before and after the invention, all participants were instructed to evaluate the intensity and unpleasantness of empathy for pain while watching different pictures with pain or non-pain conditions. The Multidimensional Assessment of Interoceptive Awareness (MAIA) was then administered to measure interoceptive awareness. The results indicated a significant interaction between group and time with regard to empathy for pain and MAIA. The DB group showed a statistically significant decrease in both pain intensity and unpleasantness during the pain picture condition, as well as a noteworthy increase in MAIA scores. The control group did not demonstrate any substantial changes. More importantly, the regulation of attention, a dimension of MAIA, had a significant mediating effect on the impact of diaphragmatic breathing on reported unpleasantness. Diaphragmatic breathing could serve as a simple, convenient, and practical strategy to optimize human empathy for pain that warrants further investigation, which has important implications not only for individuals with impaired empathy for pain but also for the improvement of interoceptive awareness.
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Affiliation(s)
- Yaping He
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Likun Ge
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajin Yuan
- Sichuan Key Laboratory of Psychology and Behavior of Discipline Inspection and Supervision, Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Yingying Wang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Danni Zheng
- School of Psychology, Beijing Sport University, Beijing, China
| | - An Rui
- School of Psychology, Beijing Sport University, Beijing, China
| | - Jun Song
- Experimental Research Center of China Academy of Chinese Medical Sciences, National Chinese Medicine Experts Inheritance Office, Beijing, China
| | - Li Hu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Gao-Xia Wei
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Mandlik GV, Siopis G, Nguyen B, Ding D, Edwards KM. Effect of a single session of yoga and meditation on stress reactivity: A systematic review. Stress Health 2024; 40:e3324. [PMID: 37822096 DOI: 10.1002/smi.3324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/10/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023]
Abstract
This systematic review synthesises the evidence for the effectiveness of a single session of yoga or its components including meditation and breathing techniques in reducing acute stress reactivity in healthy adults. Following the PRISMA guidelines, we searched Medline, EMBASE, Cochrane, CINAHL, and PsycINFO on 30th July 2023 for randomised controlled or crossover trials of yoga components and reporting physiological and/or psychological outcome measure(s) related to stress reactivity. Risk of bias (ROB) was assessed using the Cochrane ROB 2 tool. Data were synthesised narratively. Twenty-one out of 28 eligible studies (n = 2574) relating to 31 interventions (meditation [n = 22], breathing [n = 4] and yoga [n = 5]) reported outcomes in favour of the intervention. Stress reactivity was reported to be reduced by 71% of studies measuring physiological outcomes and 65% of studies measuring psychological outcomes. These studies show that a single session of yoga components is effective in reducing acute stress reactivity in adults and could be recommended for stress management. Future studies with larger populations and a more equal representation of genders and age groups are warranted.
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Affiliation(s)
- Gandhar V Mandlik
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - George Siopis
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Binh Nguyen
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ding Ding
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kate M Edwards
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Schepis TS, Rogers AH, Munoz L, Zvolensky MJ. Indirect effects of emotion regulation in the relationship between pain and cannabis use in adults 18-64 years. Addict Behav 2024; 153:107983. [PMID: 38367507 PMCID: PMC11360606 DOI: 10.1016/j.addbeh.2024.107983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/19/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Abstract
INTRODUCTION Individuals with chronic pain often receive prescription opioid medication, and they may use cannabis to treat pain as well, although the risks of cannabis-opioid co-use are significant. This study aimed to investigate whether two transdiagnostic factors, emotion regulation and distress tolerance, had significant indirect effects in the relationship between pain and cannabis use in adults with chronic pain and an opioid prescription. METHODS Participants (n = 450; mean age = 38.6 ± 11.09) were recruited using Qualtrics panel service and were 75 % female and 79 % White, non-Hispanic. Participants completed a 30-minute self-report survey capturing three-month cannabis use, the Difficulties in Emotional Regulation Scale (DERS), and the Distress Tolerance Scale (DTS). The Graded Pain Scale (GCPS) assessed pain severity/intensity and disability. Analyses used the SPSS PROCESS macro, with both single (i.e., one transdiagnostic factor) and parallel indirect effects (i.e., both the DERS and DTS) examined. RESULTS There were statistically significant indirect effects for both the DERS and DTS in the relationship between pain intensity or disability and three-month cannabis use in single factor models. In the parallel indirect effect model, only the DERS was statistically significant (intensity indirect effect coefficient = 0.0195 % confidence interval [95 %CI] = 0.0065, 0.390; disability indirect effect coefficient = 0.0147, 95 %CI = 0.0055, 0.0274). CONCLUSIONS When examining parallel indirect effects, only emotional regulation and not distress tolerance mediated the relationship between chronic pain and cannabis use among those with an opioid prescription. Clinically, interventions aimed at improving emotional regulation in individuals with chronic pain can help limit cannabis and opioid co-use.
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Affiliation(s)
- Ty S Schepis
- Department of Psychology, Texas State University, USA; Translational Health Research Center, Texas State University, USA; Center for the Study of Drugs, Alcohol, Smoking, and Health, University of Michigan, USA.
| | - Andrew H Rogers
- Department of Psychology, University of Houston, USA; Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA; Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, WA, USA
| | - Liliana Munoz
- Department of Psychology, Texas State University, USA
| | - Michael J Zvolensky
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, USA; HEALTH Institute, University of Houston, USA
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Thakur N, Baumann N. Mindfully missing myself: Induced mindfulness causes alienation among poor self-regulators. PLoS One 2024; 19:e0303505. [PMID: 38771786 PMCID: PMC11108221 DOI: 10.1371/journal.pone.0303505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/25/2024] [Indexed: 05/23/2024] Open
Abstract
Mindfulness is a popular technique that helps people to get closer to their self. However, recent findings indicate that mindfulness may not benefit everybody. In the present research, we hypothesized that mindfulness promotes alienation from the self among individuals with low abilities to self-regulate affect (state-oriented individuals) but not among individuals with high abilities to self-regulate affect (action-oriented individuals). In two studies with participants who were mostly naïve to mindfulness practices (70% indicated no experience; N1 = 126, 42 men, 84 women, 0 diverse, aged 17-86 years, Mage = 31.87; N2 = 108, 30 men, 75 women, 3 diverse, aged 17-69 years, Mage = 28.00), we tested a mindfulness group (five-minute mindfulness exercise) against a control group (five-minute text reading). We operationalized alienation as lower consistency in repeated preference judgments and a lower tendency to adopt intrinsic over extrinsic goal recommendations. Results showed that, among state-oriented participants, mindfulness led to significantly lower consistency of preference judgments (Study 1) and lower adoption of intrinsic over extrinsic goals (Study 2) compared to text reading. The alienating effect was absent among action-oriented participants. Thus, mindfulness practice may alienate psychologically vulnerable people from their self and hamper access to preferences and intrinsic goals. We discuss our findings within Personality-Systems-Interactions (PSI) theory.
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Affiliation(s)
- Niyati Thakur
- Department of Differential Psychology, Personality Psychology and Diagnostics, University of Trier, Trier, Germany
| | - Nicola Baumann
- Department of Differential Psychology, Personality Psychology and Diagnostics, University of Trier, Trier, Germany
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Nastaj J, Skalski J, Budzisz A, Szikszay TM, Swoboda S, Kowalska W, Nowak D, Zbroja E, Kruszyna N, Jakubińska M, Grygny D, Polczyk R, Małecki A, Luedtke K, Adamczyk WM. Spatial summation of pain is associated with pain expectations: Results from a home-based paradigm. PLoS One 2024; 19:e0297067. [PMID: 38300918 PMCID: PMC10833545 DOI: 10.1371/journal.pone.0297067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 12/23/2023] [Indexed: 02/03/2024] Open
Abstract
The purpose of this study was to reproduce the previously observed spatial summation of pain effect (SSp) using non-laboratory procedures and commercial equipment. An additional aim was to explore the association between expectations and SSp. The Cold Pressor Task (CPT) was used to induce SSp. Healthy participants (N = 68) immersed their non-dominant hands (divided into 5 segments) into cold water (CPT). Two conditions were used 1) gradual hand immersion (ascending condition) and 2) gradual hand withdrawal (descending condition). Pain intensity was measured on a Visual Analogue Scale (VAS). Psychological factors, such as the participants' expectations of pain intensity were also measured on a VAS. Results showed significant SSp (χ2(4) = 116.90, p < 0.001), reproduced with non-laboratory equipment in a home-based set-up. Furthermore, two novel findings were observed: i) there was a significant correlation between expectations and perceived pain, indicating a link between pain expectations and SSp, ii) spatial summation increased with the increase in duration exposure to the noxious stimulus (Wald χ2(8) = 80.80, p < 0.001). This study suggests that SSp is associated with pain expectations and can be formed by a mixture of excitatory and inhibitory mechanisms potentially driven by temporal characteristics of neural excitation. Moreover, this study proposes a new feasible way to induce SSp using a home-based set-up.
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Affiliation(s)
- Jakub Nastaj
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Jacek Skalski
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Aleksandra Budzisz
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tibor M. Szikszay
- Institute of Health Sciences, Department of Physiotherapy, Pain & Exercise Research Lübeck, Universität zu Lübeck, Lübeck, Germany
| | - Sylwia Swoboda
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Weronika Kowalska
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Daria Nowak
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Edyta Zbroja
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Natalia Kruszyna
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Marta Jakubińska
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Dominika Grygny
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Romuald Polczyk
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | - Andrzej Małecki
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Kerstin Luedtke
- Institute of Health Sciences, Department of Physiotherapy, Pain & Exercise Research Lübeck, Universität zu Lübeck, Lübeck, Germany
| | - Wacław M. Adamczyk
- Laboratory of Pain Research, Institute of Physiotherapy and Health Science, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Ye X, Li Y, Zheng Q, Liu Y, Yan S, Lian Q, Lin Y, Chen X, Chen L, Liu T. The Effect of Mindfulness on Death Escape Acceptance in Young People: Emotion Regulation as a Mediator. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241228730. [PMID: 38243735 DOI: 10.1177/00302228241228730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
Few studies have examined young people's attitudes toward death escape acceptance and its relationship to mindfulness. This study addressed this issue and examined the mediating role of emotion regulation. In Study 1, 61 undergraduate students aged 19-22 years participated in a mindfulness intervention program, and the results showed that increasing young people's levels of mindfulness could improve their attitudes toward death escape acceptance. The Study 2, which recruited 440 young people aged 18-26 years to complete a cross-sectional survey, replicated the main effect and showed that young people's difficulty in emotion regulation fully mediated the coping effect of mindfulness. These findings suggest that individuals with high levels of mindfulness may have low levels of difficulty in emotion regulation and in turn promote healthy attitudes toward death escape acceptance.
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Affiliation(s)
- Xin Ye
- School of Health, Fujian Medical University, Fuzhou, China
| | - Yang Li
- Mental Health Education Center, Huizhou Health Sciences Polytechnic, Huizhou, China
- Faculty of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Qiuyue Zheng
- School of Health, Fujian Medical University, Fuzhou, China
| | - Yang Liu
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Shizhen Yan
- School of Health, Fujian Medical University, Fuzhou, China
| | - Qiaoping Lian
- Psychological Center, Minjiang University, Fuzhou, China
| | - Yicong Lin
- The Third Hospital of Anxi County, Quanzhou, China
| | - Xiayan Chen
- School of Psychological Center, Southern Medical University, Guangzhou, China
| | - Liangliang Chen
- Department of Developmental and Behavioral Pediatrics, Fujian Children's Hospital, Fuzhou, China
| | - Tao Liu
- School of Health, Fujian Medical University, Fuzhou, China
- School of Management, Shanghai University, Shanghai, China
- School of Education, Zhejiang University, Hangzhou, China
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8
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Ferreira-Valente A, Van Dyke BP, Day MA, Teotónio do Carmo C, Pais-Ribeiro J, Pimenta F, Costa RM, Jensen MP. Immediate Effects of Hypnosis, Mindfulness Meditation, and Prayer on Cold Pressor Outcomes: A Four-Arm Parallel Experimental Study. J Pain Res 2022; 15:4077-4096. [PMID: 36582659 PMCID: PMC9793782 DOI: 10.2147/jpr.s388082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/12/2022] [Indexed: 12/25/2022] Open
Abstract
Purpose Previous research supports the usefulness of hypnosis (HYP), mindfulness meditation (MM), and prayer as pain self-management strategies in adults with chronic pain. However, their effects on acute pain have been less researched, and no previous head-to-head study compared the immediate effects of these three approaches on pain-related outcomes. This study compared the immediate effects of HYP, MM, and Christian prayer (CP) on pain intensity, pain tolerance, and stress as assessed by heart rate variability (HRV). Participants and Methods A total of 232 healthy adults were randomly assigned to, and completed, a single 20-minute session of MM, SH, CP, or an attention control (CN), and underwent two cycles (one pre- and one post-intervention) of Cold Pressor Arm Wrap (CPAW). Sessions were audio-delivered. Participants responded to pre- and post-intervention pain intensity measurements. Pain tolerance (sec) was assessed during the CPAW cycles. HRV was assessed at baseline, and at pre- and post-intervention CPAW cycles. The study protocol was pre-registered at the ClinicalTrials.gov registry (NCT04491630). Results Small within-group decreases in pain intensity and small increases in pain tolerance were found for HYP and MM from the pre- to the post-intervention. Small within-group improvements in the LH/HF ratio were also found for HYP. The exploratory between-group pairwise comparisons revealed a medium effect size effects of HYP on pain tolerance relative to the control condition. The effects of CP were positive, but small and not statistically significant. Only small to medium, though non-significant, Time × Group interaction effects were found. Conclusion Study results suggest that single short-term HYP and MM sessions, but not biblical-based CP, may be useful for acute pain self-management, with HYP being the slightly superior option. Future research should compare the effects of different types of prayer and examine the predictors and moderators of these pain approaches' effects on pain-related outcomes.
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Affiliation(s)
- Alexandra Ferreira-Valente
- William James Center for Research, Ispa – University Institute, Lisbon, Portugal,Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA,Research Center for Human Development, Faculty of Education and Psychology, Universidade Católica Portuguesa, Porto, Portugal,Correspondence: Alexandra Ferreira-Valente, Research Center for Human Development, Faculty of Education and Psychology, Universidade Católica Portuguesa, Rua de Diogo Botelho, Porto, 1327 4169-005, Portugal, Tel +351 226196200, Email
| | | | - Melissa A Day
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA,School of Psychology, Faculty of Health & Behavioral Sciences, University of Queensland, Brisbane, Australia
| | | | - José Pais-Ribeiro
- William James Center for Research, Ispa – University Institute, Lisbon, Portugal
| | - Filipa Pimenta
- William James Center for Research, Ispa – University Institute, Lisbon, Portugal
| | - Rui M Costa
- William James Center for Research, Ispa – University Institute, Lisbon, Portugal
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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A Brief Mindfulness Intervention for Parents and Children before Pediatric Venipuncture: A Randomized Controlled Trial. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121869. [PMID: 36553313 PMCID: PMC9776747 DOI: 10.3390/children9121869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/14/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Routine needle procedures can be distressing for parents and children. Mindfulness interventions may be helpful for parents and children but have not been examined for pediatric needle procedures despite showing benefits in the context of pediatric chronic pain and in lab-based pain tasks. METHODS This preregistered (NCT03941717) two-arm, parallel-group randomized controlled trial examined the effects of a 5 min mindfulness intervention before pediatric venipuncture for parents and children (aged 7-12) compared to a control group on primary outcomes of child pain and fear, secondary outcomes of parent distress, and tertiary outcomes of parent ratings of child pain and fear. Moderators of parent and children's responses to the intervention were examined: state catastrophizing, trait mindfulness, and experiential avoidance. RESULTS Sixty-one parent-child dyads were randomized (31 mindfulness; 30 control). Parents and children completed measures, listened to a 5 min audio recording (mindfulness or control), and parents accompanied their child during routine venipuncture. The mindfulness intervention involved breathing and encouraging nonjudgmental attention to one's experiences, while the control condition involved an unfocused attention task. Three between-subject MANCOVAs assessed for group differences. Child pain and fear rated by children and their parents did not differ between groups. Parents in the mindfulness group were less distressed during the venipuncture than the controls. Parent state catastrophizing may have moderated the intervention effects, such that parents with moderate and high catastrophizing levels had lower distress following the mindfulness intervention versus control. CONCLUSIONS The intervention did not reduce child pain or fear but reduced parent distress. It appeared most helpful for parents catastrophizing about their child's pain, which is noteworthy as these children are prone to worse outcomes.
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10
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Gill LN, Tabry V, Taylor V, Lussier M, Martinu K, Bherer L, Roy M, Rainville P. Effects of Brief Mindfulness Interventions on the Interference Induced by Experimental Heat Pain on Cognition in Healthy Individuals. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 2:673027. [PMID: 35295494 PMCID: PMC8915756 DOI: 10.3389/fpain.2021.673027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/06/2021] [Indexed: 12/25/2022]
Abstract
Background: Pain captures attention and interferes with competing tasks demanding cognitive effort. Brief mindfulness interventions involving both conceptual learning and meditation exercises have been shown to improve attention and reduce pain sensitivity, and could potentially reduce pain interference. This study assesses the effect of a 5-day mindfulness intervention (20 min/day) on the interference produced by thermal pain on working memory performance using a 2-back task. Methods: Healthy participants were randomized into three groups exposed to mindfulness meditation training (n = 15), an active educational control intervention comprising only conceptual information on mindfulness (n = 15), or no intervention (n = 15). The two active interventions were administered in a dual-blind fashion and outcomes were assessed by research personnel blind to this allocation. Evaluation sessions were conducted before and after the interventions to assess the effect of pain on 2-back performance (pain interference). Importantly, both pain stimuli and the 2-back task were calibrated individually and in each session before assessing pain interference, thereby controlling for possible changes in baseline pain sensitivity and cognitive performance. Secondary outcomes included heat pain sensitivity, cold pain tolerance, cognitive inhibition, cognitive flexibility, and divided attention. Results: Manipulation checks confirmed that heat pain interferes with the performance of the working-memory task. Compared to the no-intervention control group, pain interference was significantly reduced following the conceptual intervention but not the meditation intervention, although a corollary analysis suggests the effect might be due to regression toward the mean caused by baseline imbalance in pain interference. Secondary outcomes also suggested an increase in pain tolerance in the conceptual learning group only. Discussion: A short mindfulness meditation intervention was insufficient to reduce pain interference but conceptual learning about mindfulness produced some unexpected benefits. Although the generalization of experimental findings to clinical pain conditions may be premature, these results highlight the importance of distinguishing the contribution of mindfulness education and meditation training in future studies. Understanding the effects of mindfulness training on pain regulation and management must take into consideration the multiple factors underlying this complex intervention.
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Affiliation(s)
- Louis-Nascan Gill
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Vanessa Tabry
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Véronique Taylor
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Maxime Lussier
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Kristina Martinu
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Louis Bherer
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Center for Research, Montreal Heart Institute, Montreal, QC, Canada
| | - Mathieu Roy
- Department of Psychology, McGill University, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Pierre Rainville
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Department of Stomatology, Université de Montréal, Montreal, QC, Canada
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11
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How do placebo effects contribute to mindfulness-based analgesia? Probing acute pain effects and interactions using a randomized balanced placebo design. Pain 2022; 163:1967-1977. [PMID: 35082252 DOI: 10.1097/j.pain.0000000000002593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Recent sham-controlled studies suggest placebo effects contribute to acute pain relief following mindfulness interventions. However, the specific effects of mindfulness processes and their interaction with placebo effects remain unclear. This study aimed to characterize the role of mindfulness and placebo processes underlying mindfulness-based pain attenuation. Both treatment (focused-attention mindfulness vs sham) and instruction ("told mindfulness" vs "told sham") were manipulated in a balanced placebo design. Changes in acute heat pain were evaluated in 153 healthy adults randomized to receive 6 x 20 minutes of one of the four treatment by instruction interventions or no treatment. Participants receiving any intervention demonstrated improved pain outcomes (unpleasantness, intensity and tolerance) relative to no treatment. The instruction manipulation increased expectation for pain relief in those told mindfulness relative to told sham, but there were no main effects or interactions of treatment or instruction on pain outcomes. However, irrespective of actual intervention received, the belief of receiving mindfulness predicted increased pain threshold and tolerance, with expectancy fully mediating the effect on pain tolerance. These findings suggest a lack of specific effects of mindfulness and instruction on acute pain. Nonetheless, participants' expectancies and beliefs about the treatment they received did predict pain relief. Together with the overall improvement following any intervention, these findings suggest that expectancy and belief may play a stronger role in attenuating acute pain in novices following brief mindfulness interventions than the actual mindfulness-specific processes or instructions delivered.
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Wu Q, Mao X, Luo W, Fan J, Liu X, Wu Y. Enhanced interoceptive attention mediates the relationship between mindfulness training and the reduction of negative mood. Psychophysiology 2021; 59:e13991. [PMID: 34932832 DOI: 10.1111/psyp.13991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022]
Abstract
Although accumulating evidence has revealed the effect of mindfulness training on the reduction of general stress and the improvement of mental well-being, the underlying mechanism remains unclear. In this study, we investigated whether interoceptive attention to respiratory signals plays a role. Healthy adults were randomly assigned to either receive an 8-week mindfulness training (n = 29) or inactive control (n = 28). The pre- and post-training self-reported states of negative mood were assessed together with an objective measure of interoceptive attention to respiration. Compared to the control group, mindfulness training led to a decrease in the level of negative mood and an increase in interoceptive sensitivity. Mediation analysis further showed that the effect of mindfulness training on the reduction of negative mood was fully mediated by increased interoceptive sensitivity. These results suggest that mindfulness training effectively alleviates negative mood by enhancing interoceptive attention to respiratory signals.
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Affiliation(s)
- Qiong Wu
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Xinrui Mao
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Wei Luo
- Chinese Academy of Social Sciences, Beijing, China
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, New York, New York, USA
| | - Xinghua Liu
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.,Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yanhong Wu
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China.,Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
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13
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Mindfulness-Based Analgesia or Placebo Effect? The Development and Evaluation of a Sham Mindfulness Intervention for Acute Experimental Pain. Psychosom Med 2021; 83:557-565. [PMID: 33165219 DOI: 10.1097/psy.0000000000000886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Meta-analyses indicate that mindfulness meditation is efficacious for chronic and acute pain, but most available studies lack active control comparisons. This raises the possibility that placebo-related processes may account, at least in part, for mindfulness effects. The objective of this study was to develop a closely matched sham mindfulness condition to establish whether placebo effects contribute to mindfulness-based interventions for pain. METHODS We developed and validated a closely matched sham mindfulness intervention then compared it with 6 × 20-minute sessions of focused-attention mindfulness and a no-treatment condition in 93 healthy volunteers undergoing acute experimental heat pain. RESULTS The sham mindfulness intervention produced equivalent credibility ratings and expectations of improvement as the mindfulness intervention but did not influence mindfulness-related processes. In contrast, mindfulness increased "observing" relative to no treatment but not sham. Mindfulness (F(1,88) = 7.06, p = .009, ηp2 = 0.07) and sham (F(1,88) = 6.47, p = .012, ηp2 = 0.07) moderately increased pain tolerance relative to no treatment, with no difference between mindfulness and sham (F(1,88) = 0.01, p = .92, ηp2 < 0.001). No differences were found for pain threshold. Similarly, neither mindfulness nor sham reduced pain intensity or unpleasantness relative to no treatment, although mindfulness reduced pain unpleasantness relative to sham (F(1,88) = 5.03, p = .027, ηp2 = 0.05). CONCLUSIONS These results suggest that placebo effects contribute to changes in pain tolerance after mindfulness training, with limited evidence of specific effects of mindfulness training on pain unpleasantness relative to sham, but not no treatment. To disentangle the specific analgesic effects of mindfulness from placebo-related processes, future research should prioritize developing and incorporating closely matched sham conditions.Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12618001175268).
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Ferreira-Valente A, Pimenta F, Costa RM, Day MA, Pais-Ribeiro J, Jensen MP. COPAHS Study: protocol of a randomised experimental study comparing the effects of hypnosis, mindfulness meditation, and spiritual practices on experimental pain in healthy adults. BMJ Open 2021; 11:e040068. [PMID: 33558346 PMCID: PMC7871695 DOI: 10.1136/bmjopen-2020-040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/23/2020] [Accepted: 01/21/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There has been an increasing interest in studying the potential benefits of so-called complementary and alternative approaches for pain management, such as hypnosis and mindfulness-based interventions. More recently, researchers have been interested in studying the effects of spiritual practices on pain experience as well. These practices may increase pain tolerance, result in a positive re-appraisal of pain and influence other psychological variables that are known to be associated with pain experience. The purpose of this study is to evaluate and compare the immediate effects of self-hypnosis, mindfulness meditation, and a spiritual intervention relative to a control condition for increasing pain tolerance and reducing pain intensity and pain-related stress, in response to experimental painful stimulation. METHODS AND ANALYSIS Recruitment is anticipated to start in November 2020. This is a randomised quantitative experimental mixed-design repeated-measures study with three assessment points: baseline (T0), pre-test (T1) and post-test (T2). Eligible healthy adults will be randomised to one of the four study conditions. Interventions will be a 20-minute audio-guided practice of either self-hypnosis, mindfulness meditation, or Christian prayer. Participants in the control group will not be instructed to use any specific strategy during the painful stimulation. Participants will be submitted to a first cycle of Cold Pressor Arm Wrap. They will then listen to a 20-minute audio recording inducing one of the three interventions, or, in the case of the control group, to a 20-minute audio recording of text from a natural history textbook. Primary outcomes are pain intensity and pain tolerance. Pain-related stress as measured by salivary cortisol level and heart rate variability are secondary outcomes. ETHICS AND DISSEMINATION This study was approved by ISPA-University Institute's internal Ethics Committee for Research on 3rd December 2018 (reference I/010/12/2018). Findings will be published in peer-reviewed indexed journals and presented at conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov registry (NCT04491630). Stage: pre-results.
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Affiliation(s)
- Alexandra Ferreira-Valente
- William James Center for Research, ISPA - University Institute, Lisbon, Portugal
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Filipa Pimenta
- William James Center for Research, ISPA - University Institute, Lisbon, Portugal
| | - Rui M Costa
- William James Center for Research, ISPA - University Institute, Lisbon, Portugal
| | - Melissa A Day
- The University of Queensland, School of Psychology, Saint Lucia, Queensland, Australia
| | - José Pais-Ribeiro
- William James Center for Research, ISPA - University Institute, Lisbon, Portugal
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
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15
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Greenberg J, Mace RA, Bannon SM, Kulich RJ, Vranceanu AM. Mind-Body Activity Program for Chronic Pain: Exploring Mechanisms of Improvement in Patient-Reported, Performance-Based and Ambulatory Physical Function. J Pain Res 2021; 14:359-368. [PMID: 33574699 PMCID: PMC7872894 DOI: 10.2147/jpr.s298212] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/20/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Improving physical function among patients with chronic pain is critical for reducing disability and healthcare costs. However, mechanisms underlying improvement in patient-reported, performance-based, and ambulatory physical function in chronic pain remain poorly understood. PURPOSE To explore psychosocial mediators of improvement in patient-reported, performance-based, and objective/accelerometer-measured physical function among participants in a mind-body activity program. METHODS Individuals with chronic pain were randomized to one of two identical 10-week mind-body activity interventions aimed at improving physical function with (GetActive-Fitbit; N=41) or without (GetActive; N=41) a Fitbit device. They completed self-reported (WHODAS 2.0), performance-based (6-minute walk test), and objective (accelerometer-measured step-count) measures of physical function, as well as measures of kinesiophobia (Tampa Kinesiophobia Scale), mindfulness (CAMS-R), and pain resilience (Pain Resilience Scale) before and after the intervention. We conducted secondary data analyses to test mediation via mixed-effects modeline. RESULTS Improvements in patient-reported physical function were fully and uniquely mediated by kinesiophobia (Completely Standardized Indirect Effect (CSIE)=.18; CI=0.08, 0.30; medium-large effect size), mindfulness (CSIE=-.14; CI=-25, -.05; medium effect size) and pain resilience (CSIE=-.07; CI=-.16, -.005; small-medium effect size). Improvements in performance-based physical function were mediated only by kinesiophobia (CSIE=-.11; CI=-23, -.008; medium effect size). No measures mediated improvements in objective (accelerometer measured) physical function. CONCLUSION Interventions aiming to improve patient-reported physical function in patients with chronic pain may benefit from skills that target kinesiophobia, mindfulness, and pain resilience, while those focused on improving performance-based physical function should target primarily kinesiophobia. More research is needed to understand mechanisms of improvement in objective, accelerometer-measured physical function. TRIAL REGISTRATION ClinicalTrials.gov NCT03412916.
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Affiliation(s)
- Jonathan Greenberg
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ryan A Mace
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah M Bannon
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ronald J Kulich
- Harvard Medical School, Boston, MA, USA
- Center for Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
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16
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Pollonini L, Hernandez SAM, Park L, Miao H, Mathis K, Ahn H. Functional Near-Infrared Spectroscopy to Assess Central Pain Responses in a Nonpharmacologic Treatment Trial of Osteoarthritis. J Neuroimaging 2020; 30:808-814. [PMID: 32896933 PMCID: PMC7719610 DOI: 10.1111/jon.12782] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/31/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE Knee osteoarthritis (OA) is a common source of pain in older adults. Although OA-induced pain can be relieved with analgesics and anti-inflammatory drugs, the current opioid epidemic is fostering the exploration of nonpharmacologic strategies for pain mitigation. Amongs these, transcranial direct current stimulation (tDCS) and mindfulness-based meditation (MBM) hold potential for pain-relief efficacy due to their neuromodulatory effects of the central nervous system, which is known to play a fundamental role in pain perception and processing. METHODS In this double-blind study, we used functional near-infrared spectroscopy (fNIRS) to investigate the effects of tDCS combined with MBM on underlying pain processing mechanisms at the central nervous level in older adults with knee OA. Nineteen subjects were randomly assigned to two groups undergoing a 10-day active tDCS and MBM regimen and a sham tDCS and MBM regimen, respectively. RESULTS Our results showed that the neuromodulatory intervention significantly relieved pain only in the group receiving active treatment. We also found that only the active treatment group showed a significant increase in oxyhemoglobin activation of the superior motor and somatosensory cortices colocated to the placement of the tDCS anodal electrode. To our knowledge, this is the first study in which the combined effect of tDCS and MBM is investigated using fNIRS. CONCLUSION In conclusion, fNIRS can be effectively used to investigate neural mechanisms of pain at the cortical level in association with nonpharmacological, self-administered treatments.
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Affiliation(s)
- Luca Pollonini
- Department of Engineering Technology, University of Houston, Houston, TX, USA
- Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA
| | | | - Lindsey Park
- Cizik School of Nursing, University of Texas Health Science Center, Houston, TX, USA
| | - Hongyu Miao
- School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | - Kenneth Mathis
- Department of Orthopedic Surgery, School of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hyochol Ahn
- Cizik School of Nursing, University of Texas Health Science Center, Houston, TX, USA
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Tsur N, Defrin R, Haller CS, Bercovitz K, Langer EJ. The effect of mindful attention training for pain modulation capacity: Exploring the mindfulness-pain link. J Clin Psychol 2020; 77:896-909. [PMID: 32997348 DOI: 10.1002/jclp.23063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 05/02/2020] [Accepted: 08/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Mindfulness has been shown to be beneficial for chronic pain. The underlying mechanisms of the mindfulness-pain link, however, are yet to be established. Particularly, the effects of mindfulness on pain modulation, which is shown to be dysfunctional among chronic pain patients, barely has been tested. This study investigated whether a short mindful attention training based on Langerian mindfulness mitigates reductions in pain modulation. METHOD Systemic quantitative-somatosensory testing of conditioned pain modulation (CPM) was conducted in 60 undergraduates, who were randomly assigned to one of three groups: (1) Pain-specific mindful attention training; (2) nonspecific mindful attention training; and (3) no mindful attention training. CPM was tested before and after the intervention. RESULTS As hypothesized, a reduction in CPM magnitude was observed only in the control group, whereas this reduction was abolished in the two mindfulness groups. CONCLUSIONS Langerian mindfulness may mitigate pain modulation reduction as observed in chronic pain, thus shedding light on its potential advantages.
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Affiliation(s)
- Noga Tsur
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.,Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Ruth Defrin
- Department of Physical Therapy, School of Allied Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chiara S Haller
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.,Division of Public Psychiatry, Massachusetts Mental Health Center, Harvard Medical School, Boston, MA, USA.,Cognicreate LLC, Cambridge, MA, USA
| | | | - Ellen J Langer
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
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18
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Moline RL, Chambers C, McMurtry CM. Study protocol for a randomized controlled trial of a child and parent mindfulness intervention for pediatric venipuncture. PAEDIATRIC & NEONATAL PAIN 2020; 3:20-28. [PMID: 35548848 PMCID: PMC8975227 DOI: 10.1002/pne2.12038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/11/2020] [Accepted: 07/29/2020] [Indexed: 12/17/2022]
Abstract
Children commonly undergo painful needle procedures. Unmanaged procedural pain can have short‐ and long‐term consequences, including longer procedure times, greater distress at future procedures, and vaccine hesitancy. While parent behaviors are one of the strongest predictors of children's response to acute pain, pediatric procedural pain management interventions focus almost exclusively on the child. Further, existing parent‐involved pediatric pain management interventions typically fail to improve child self‐reported pain during painful procedures. The current protocol offers the first randomized controlled trial involving a mindfulness intervention for pediatric acute pain that includes children and their parents. This study aims to conduct a single‐site, two‐arm, parallel‐group RCT to examine the effects of a mindfulness intervention for parents and children before child venipuncture compared to a control group on primary (child self‐report of pain and fear), secondary (parent self‐report and child report of parent distress), and tertiary outcomes (parent report of child pain and fear). Parent‐child dyads (n = 150) will be recruited from the McMaster Children's Hospital outpatient blood laboratory. Dyads will be randomly assigned to either a mindfulness group guided through a mindfulness intervention or control group guided through an unfocused attention task. Parents will accompany their child for their venipuncture. Postvenipuncture measures will be collected (eg, child pain‐related outcomes as reported by parents and children). The first enrollment occurred in October 2019. We offer a novel intervention that aims to facilitate both parent and child coping during child venipuncture. The current protocol offers the first randomized controlled trial involving a mindfulness intervention for pediatric acute pain that includes children and their parents. This study aims to conduct a single‐site, two‐arm, parallel‐group RCT to examine the effects of a mindfulness intervention for parents and children (aged 7‐12) before child venipuncture compared to a control group on primary (child self‐report of pain and fear), secondary (parent self‐report and child report of parent distress), and tertiary outcomes (parent report of child pain and fear). We offer a novel intervention that aims to facilitate both parent and child coping during child venipuncture.
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Affiliation(s)
- Rachel L Moline
- Department of Psychology University of Guelph Guelph ON Canada
| | - Christine Chambers
- Department of Psychology and Neuroscience Dalhousie University Halifax NS Canada.,Department of Pediatrics Dalhousie University Halifax NS Canada.,Centre for Pediatric Pain Research IWK Health Centre Halifax NS Canada
| | - C Meghan McMurtry
- Department of Psychology University of Guelph Guelph ON Canada.,Pediatric Chronic Pain Program McMaster Children's Hospital Hamilton ON Canada.,Department of Paediatrics Schulich School of Medicine & Dentistry Western University London ON Canada
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19
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Shires A, Sharpe L, Davies JN, Newton-John TRO. The efficacy of mindfulness-based interventions in acute pain: a systematic review and meta-analysis. Pain 2020; 161:1698-1707. [PMID: 32701830 DOI: 10.1097/j.pain.0000000000001877] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent meta-analyses have shown mindfulness-based interventions (MBIs) to be effective for chronic pain, but no pooled estimates of the effect of MBIs on acute pain are available. This meta-analysis was conducted to fill that gap. A literature search was conducted in 4 databases. Articles were eligible if they reported on randomized controlled trials of MBIs for people with acute pain and one of the following outcomes: pain severity, pain threshold, pain tolerance, or pain-related distress. Two authors independently extracted the data, assessed risk of bias, and provided GRADE ratings. Twenty-two studies were included. There was no evidence of an effect of MBIs on the primary outcome of pain severity in clinical {Hedges' g = 0.52; (95% confidence interval [CI] -0.241 to 1.280)} or experimental settings (Hedges' g = 0.04; 95% CI [-0.161 to 0.247]). There was a beneficial effect of MBIs on pain tolerance (Hedges' g = 0.68; 95% CI [0.157-1.282]) and pain threshold (Hedges' g = 0.72; 95% CI [0.210-1.154]) in experimental studies. There was no evidence of an effect of MBIs compared to control for pain-related distress in clinical (Hedges' g = 0.16; 95% CI [-0.018 to 0.419]) or experimental settings (Hedges' g = 0.44; 95% CI [-0.164 to 0.419]). GRADE assessment indicated that except for pain tolerance, the data were of low or very low quality. There is moderate evidence that MBIs are efficacious in increasing pain tolerance and weak evidence for pain threshold. However, there is an absence of good-quality evidence for the efficacy of MBIs for reducing the pain severity or pain-related distress in either clinical or experimental settings.
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Affiliation(s)
- Alice Shires
- School of Psychology, University of Sydney, Sydney, NSW, Australia
- Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Louise Sharpe
- School of Psychology, University of Sydney, Sydney, NSW, Australia
| | | | - Toby R O Newton-John
- Graduate School of Health, University of Technology Sydney, New South Wales, Australia
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20
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Belschner L, Lin SY, Yamin DF, Best JR, Edalati K, McDermid J, Stewart SE. Mindfulness-based skills training group for parents of obsessive-compulsive disorder-affected children: A caregiver-focused intervention. Complement Ther Clin Pract 2020; 39:101098. [PMID: 32379640 DOI: 10.1016/j.ctcp.2020.101098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Parents of children with obsessive-compulsive disorder (OCD) report significant emotional and socio-occupational impacts. There is, however, currently insufficient support for these parents. This study examined a mindfulness-based intervention for parents of OCD-affected children, investigating its feasibility and impact on parental ability to tolerate their child's OCD-related distress, in addition to exploring potential indirect effects. MATERIALS AND METHODS Parents of OCD-affected children (n = 39) completed an eight-week baseline observation period followed by eight, weekly manualized mindfulness-based intervention group sessions. Measures of parental tolerance of child distress, dispositional mindfulness, family accommodation, family functioning, and OCD symptom severity were collected. RESULTS In comparison to the baseline observation period, parental tolerance of child distress and dispositional mindfulness significantly improved following mindfulness training. No other temporal differences were observed. Parents reported high satisfaction. CONCLUSION Mindfulness-based skills training for parents of OCD-affected youth appears to be feasible and to significantly increase tolerance related to the child's distress. CLINICAL TRIAL REGISTRATION NUMBER NCT03212703.
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Affiliation(s)
- Laura Belschner
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; British Columbia Children's Hospital Research Institute, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - Sarah Yao Lin
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; British Columbia Children's Hospital Research Institute, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - Diana Franco Yamin
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; British Columbia Children's Hospital Research Institute, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - John R Best
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; British Columbia Children's Hospital Research Institute, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - Kourosh Edalati
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; British Columbia Children's Hospital Research Institute, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - Joanna McDermid
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; BC Children's Hospital Centre for Mindfulness, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
| | - S Evelyn Stewart
- Psychiatry, Faculty of Medicine, University of British Columbia, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; British Columbia Children's Hospital Research Institute, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada; BC Children's Hospital Centre for Mindfulness, A3-121, 938 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.
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Targeting cognitive and emotional regulatory skills for smoking prevention in low-SES youth: A randomized trial of mindfulness and working memory interventions. Addict Behav 2020; 104:106262. [PMID: 31918169 DOI: 10.1016/j.addbeh.2019.106262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/14/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022]
Abstract
Research to date provides striking evidence that youth from low socio-economic status (SES) households are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities have identified working memory and distress tolerance as potential crucial modifiable risk factors to prevent smoking onset in this cohort. To confirm the value of these mechanistic targets, this randomized trial was designed to evaluate the influence of working memory and distress tolerance interventions on risk of smoking initiation. Recruiting primarily from low-income community afternoon programs, we randomized 93 adolescents to one of three intervention conditions, all of which were a prelude to a smoking-prevention informational intervention: (1) a working memory intervention, (2) a mindfulness training intervention to target distress tolerance, and (3) a wellness-focused control condition. Despite a number of adherence efforts, engagement in treatment was limited, and under these conditions no significant evidence was found either for differential efficacy for smoking prevention or for intervention effects on mechanistic targets. However, working memory capacity and distress tolerance were found to be negatively related to smoking propensity. As such, our mechanistic targets-working memory and distress tolerance--may well be processes undergirding smoking, despite the fact that our interventions did not adequately engage these targets.
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Pendrous R, Hulbert-Williams L, Hochard KD, Hulbert-Williams NJ. Appetitive augmental functions and common physical properties in a pain-tolerance metaphor: An extended replication. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Shuai R, Bakou AE, Hardy L, Hogarth L. Ultra-brief breath counting (mindfulness) training promotes recovery from stress-induced alcohol-seeking in student drinkers. Addict Behav 2020; 102:106141. [PMID: 31704429 PMCID: PMC6959458 DOI: 10.1016/j.addbeh.2019.106141] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 01/02/2023]
Abstract
The therapeutic effect of mindfulness interventions on problematic drinking is thought to be driven by increased resilience to the impact of stress on negative mood and alcohol-seeking behaviour, but this claim needs empirical support. To address this hypothesis, the current study tested whether brief training of one component of mindfulness - breath counting - would reduce drinkers' sensitivity to the effect of noise stress on subjective mood and alcohol-seeking behaviour. Baseline alcohol-seeking was measured by choice to view alcohol versus food thumbnail pictures in 192 student drinkers. Participants then received a 6-minute audio file which either trained breath counting or recited a popular science extract, in separate groups. All participants were then stressed by a loud industrial noise and alcohol-seeking was measured again simultaneously to quantify the change from baseline. Subjective mood was measured after all three stages (baseline, post intervention, post stress test). The breath counting group were instructed to deploy this technique during the stress test. Results showed that the breath counting versus control intervention improved subjective mood relative to baseline, attenuated the worsening of subjective mood produced by stress induction, and accelerated recovery from a stress induced increase in alcohol-seeking behaviour. Exploratory moderation analysis showed that this accelerated recovery from stress induced alcohol-seeking by breath counting was weaker in more alcohol dependent participants. Mindfulness therapies may improve problematic drinking by increasing resilience to stress induced negative mood and alcohol-seeking, as observed in this study. The weaker therapeutic effect of breath counting in more dependent drinkers may reveal limitations to this intervention strategy.
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Affiliation(s)
- Ruichong Shuai
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, UK
| | - Alexandra Elissavet Bakou
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, UK
| | - Lorna Hardy
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, UK
| | - Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, UK.
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Bloom-Foster J, Mehl-Madrona L. An Ultra-Brief Mindfulness-Based Intervention for Patients in Treatment for Opioid Addiction with Buprenorphine: A Primary Care Feasibility Pilot Study. J Altern Complement Med 2020; 26:34-43. [DOI: 10.1089/acm.2019.0242] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jessica Bloom-Foster
- Family Medicine Residency, Northern Light Eastern Maine Medical Center, Bangor, ME
| | - Lewis Mehl-Madrona
- Family Medicine Residency, Northern Light Eastern Maine Medical Center, Bangor, ME
- Coyote Institute, Orono, ME
- Wabanaki Health and Wellness, Bangor, ME
- Graduate School, University of Maine, Orono, ME
- Department of Psychiatry, University of Vermont College of Medicine, Burlington, VT
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25
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Böge K, Karadza A, Fuchs LM, Ehlen F, Ta TMT, Thomas N, Bajbouj M, Hahn E. Mindfulness-Based Interventions for In-Patients With Schizophrenia Spectrum Disorders-A Qualitative Approach. Front Psychiatry 2020; 11:600. [PMID: 32676042 PMCID: PMC7333646 DOI: 10.3389/fpsyt.2020.00600] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/10/2020] [Indexed: 12/25/2022] Open
Abstract
In recent years, mindfulness-based interventions (MBI) have gained clinical relevance in the treatment of patients with schizophrenia spectrum disorders (SSDs). High symptom burden, long durations of hospitalization and high rehospitalization rates demonstrate the severity and cost-intensity of these disorders. MBIs have shown promising treatment outcomes in a small number of trials, primarily taking place in English-speaking countries. The current study aims to explore mechanisms and processes as well as adverse effects of MBIs on in-patients with SSDs in a German university hospital setting. A qualitative design based on inductive thematic analysis accompanied by quantitative assessments was chosen. A semi-structured interview guide was developed by psychiatrists and psychologists to assess patient experiences, perceptions, thoughts, and feelings during and after taking part in a MBI. Twenty-seven interviews were conducted between September 2017 and October 2018 with in-patients who are diagnosed with schizophrenia or schizoaffective disorder. Rater-based questionnaires, such as the Positive and Negative Syndrome Scale (PANSS), Montgomery Asberg Depression Rating Scale (MADRS), and Psychotic Symptom Rating Scales-Auditory Hallucination (PSYRATS-AH) were administered at baseline to collect clinical outcomes. Qualitative analysis revealed two domains: content and function. In the first domain related to content with the core elements "detachment and rumination", "presence and getting lost", "non-judgment and judgment", and effects with "emotions", "cognition", and "symptom changes". A second domain related to function was extracted, including the relevance of perception of context and transfer to everyday life. Overall, improvements concerning cognition, distress, and psychopathology were detected, while no adverse effects, such as increased psychotic symptoms, were revealed. As the first study of its kind, mechanisms, processes, and the safety of MBIs were explored and confirmed in a sample of German in-patients with SSDs. The results of this qualitative study are in line with recent findings on MBIs amongst patients with psychotic disorders from other countries. Results lay the ground for future research to focus on the systematic study of MBIs in large samples, its treatment processes, outcomes, and effectiveness for in-patients with SSDs.
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Affiliation(s)
- Kerem Böge
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Almira Karadza
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Clinical Psychology and Psychotherapy, Psychologische Hochschule Berlin, Berlin, Germany
| | - Lukas M Fuchs
- Institute of Sociology, Freie Universität Berlin, Berlin, Germany
| | - Felicitas Ehlen
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Psychiatry, Jüdisches Krankenhaus, Berlin, Germany
| | - Thi Minh Tam Ta
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Neil Thomas
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Malek Bajbouj
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Eric Hahn
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Wang Y, Qi Z, Hofmann SG, Si M, Liu X, Xu W. Effect of Acceptance versus Attention on Pain Tolerance: Dissecting Two Components of Mindfulness. Mindfulness (N Y) 2019; 10:1352-1359. [PMID: 31537989 PMCID: PMC6752222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Previous studies have shown that brief mindfulness trainings can have significant analgesic effects. However, the effects of the various components of mindfulness on pain analgesia are not well understood. The objective of this study was to examine the effects of two components of mindfulness interventions - attention and acceptance on pain analgesia. METHODS One hundred and nineteen healthy college students without prior mindfulness experience underwent a cold pressor test to measure pain tolerance before and after the training. Pain intensity, tolerance, distress, threshold and endurance time were also tested. Participants were randomly assigned to one of four conditions: (1) acceptance of pain, (2) attention to pain, (3) acceptance of and attention to pain, or (4) control. RESULTS The results showed that both the acceptance strategy and the combined acceptance and attention group increased pain endurance and tolerance after training. Furthermore, acceptance group had longer pain endurance time and tolerance time than attention group and control group. CONCLUSIONS These results suggest that acceptance of pain is more important than attention to pain. Study limitations and future research directions are discussed.
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Affiliation(s)
- Yuzheng Wang
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhenzhen Qi
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mei Si
- Department of Cognitive Science, Rensselaer Polytechnic Institute, NY, USA
| | - Xinghua Liu
- Beijing Key Laboratory of Learning and Cognition, Department of Psychology, Capital Normal University, Beijing, China
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Wei Xu
- School of Psychology, Nanjing Normal University, Nanjing, China
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Carpenter JK, Sanford J, Hofmann SG. The Effect of a Brief Mindfulness Training on Distress Tolerance and Stress Reactivity. Behav Ther 2019; 50:630-645. [PMID: 31030879 PMCID: PMC6494113 DOI: 10.1016/j.beth.2018.10.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/07/2018] [Accepted: 10/02/2018] [Indexed: 11/28/2022]
Abstract
Poor distress tolerance (DT) is considered an underlying facet of anxiety, depression, and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance or nonjudgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the nonjudge and nonreact facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.
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Affiliation(s)
- Joseph K. Carpenter
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon St, 6th floor, Boston, MA, 02215;
| | - Jenny Sanford
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon St, 6th floor, Boston, MA, 02215; ,Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114;
| | - Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, 648 Beacon St, 6th floor, Boston, MA, 02215; ,Denotes corresponding author
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28
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Pilot randomised controlled trial of a brief mindfulness-based intervention for those with persistent pain. J Behav Med 2019; 42:999-1014. [PMID: 31011944 DOI: 10.1007/s10865-019-00040-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 04/04/2019] [Indexed: 02/04/2023]
Abstract
A pilot-randomised controlled trial (RCT) examined the effects of a brief mindfulness-based intervention (MBI) on persistent pain patients and assessed the feasibility of conducting a definitive RCT. A brief (15 min) mindfulness body-scan audio was compared with an active control administered in a clinic and then used independently over 1 month. Immediate effects of the intervention were assessed with brief measures of pain severity, distraction and distress. Assessments at baseline, 1 week and 1 month included pain severity and interference, mood, pain-catastrophizing, mindfulness, self-efficacy, quality of life and intervention acceptability. Of 220 referred patients, 147 were randomised and 71 completed all assessments. There were no significant immediate intervention effects. There were significant positive effects for ratings of intervention 'usefulness' at 1 week (p = 0.044), and pain self-efficacy at 1 month (p = 0.039) for the MBI group compared with control. Evidently, it is feasible to recruit persistent pain patients to a brief MBI study. Strategies are needed to maximise retention of participants.Trial registration Current controlled trials ISRCTN61538090. Registered 20 April 2015.
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McClintock AS, McCarrick SM, Garland EL, Zeidan F, Zgierska AE. Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review. J Altern Complement Med 2019; 25:265-278. [PMID: 30523705 PMCID: PMC6437625 DOI: 10.1089/acm.2018.0351] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Nonpharmacologic approaches have been characterized as the preferred means to treat chronic noncancer pain by the Centers for Disease Control and Prevention. There is evidence that mindfulness-based interventions (MBIs) are effective for pain management, yet the typical MBI may not be feasible across many clinical settings due to resource and time constraints. Brief MBIs (BMBIs) could prove to be more feasible and pragmatic for safe treatment of pain. The aim of the present article is to systematically review evidence of BMBI's effects on acute and chronic pain outcomes in humans. METHODS A literature search was conducted using PubMed, PsycINFO, and Google Scholar and by examining the references of retrieved articles. Articles written in English, published up to August 16, 2017, and reporting on the effects of a BMBI (i.e., total contact time <1.5 h, with mindfulness as the primary therapeutic technique) on a pain-related outcome (i.e., pain outcome, pain affect, pain-related function/quality of life, or medication-related outcome) were eligible for inclusion. Two authors independently extracted the data and assessed risk of bias. RESULTS Twenty studies meeting eligibility criteria were identified. Studies used qualitative (n = 1), within-group (n = 3), or randomized controlled trial (n = 16) designs and were conducted with clinical (n = 6) or nonclinical (i.e., experimentally-induced pain; n = 14) samples. Of the 25 BMBIs tested across the 20 studies, 13 were delivered with audio/video recording only, and 12 were delivered by a provider (participant-provider contact ranged from 3 to 80 min). Existing evidence was limited and inconclusive overall. Nevertheless, BMBIs delivered in a particular format-by a provider and lasting more than 5 min-showed some promise in the management of acute pain. CONCLUSIONS More rigorous large scale studies conducted with pain populations are needed before unequivocally recommending BMBI as a first-line treatment for acute or chronic pain.
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Affiliation(s)
- Andrew S. McClintock
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Athens, Ohio
| | - Fadel Zeidan
- Department of Neurobiology and Anatomy, Center of Integrative Medicine, Wake Forrest School of Medicine, Winston-Salem, North Carolina
| | - Aleksandra E. Zgierska
- Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, Wisconsin
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30
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Pedrelli P, MacPherson L, Khan AJ, Shapero BG, Fisher LB, Nyer M, Cassano P, Parnarouskis L, Farabaugh A, Fava M, Silveri MM. Sex Differences in the Association between Heavy Drinking and Behavioral Distress Tolerance and Emotional Reactivity Among Non-Depressed College Students. Alcohol Alcohol 2019; 53:674-681. [PMID: 29947730 DOI: 10.1093/alcalc/agy045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 06/02/2018] [Indexed: 11/15/2022] Open
Abstract
Background Heavy episodic drinking (HED) is a common behavior among college students that is associated with severe negative consequences. Negative reinforcement processes have been applied to elucidate mechanisms underlying relationships between consumption of alcohol and the desire to alleviate negative feelings. Distress tolerance (DT) and emotional reactivity are two mechanisms that are consistent with the self-medication model that may contribute to HED. The current study investigated relationships between DT, emotional reactivity, defined as frustration reactivity and irritability reactivity, and HED in a non-depressed college population. Given differential patterns of consumption and motivation for drinking between males and females, sex differences were also examined. Short Summary The study examined two constructs consistent with negative reinforcement processes, behavioral distress tolerance (DT) and emotional reactivity (frustration reactivity and irritability reactivity), to explain heavy episodic drinking (HED) among non-depressed college students. Behavioral DT and frustration reactivity independently predicted HED. Higher HED was associated with higher frustration reactivity and lower behavioral DT in women, but nor in men. Methods One-hundred-ten college students without depressive symptoms completed alcohol use measures and the Paced Auditory Serial Attention Task (PASAT-C) to assess behavioral DT and emotional reactivity. Results DT and frustration reactivity independently predicted HED. The association between DT and HED was moderated by sex such that higher levels of DT predicted higher HED among females, but not among males. Higher frustration reactivity scores were associated with a greater number of HED. Conclusions Results provide supporting evidence that DT and emotional reactivity are distinct factors, and that they predict HED independently. Results underscore the importance of examining sex differences when evaluating the association between HED and negative reinforcement processes in this population.
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Affiliation(s)
- Paola Pedrelli
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Laura MacPherson
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA
| | - Amanda J Khan
- Emotion and Learning Lab, Department of Psychology, Suffolk University, Boston, MA, USA
| | - Benjamin G Shapero
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lauren B Fisher
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Maren Nyer
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Paolo Cassano
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lindsey Parnarouskis
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Farabaugh
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Maurizio Fava
- Department of Psychiatry, Depression Clinical Research Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Marisa M Silveri
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Neurodevelopmental Laboratory on Addictions and Mental Health, McLean Hospital, Belmont, MA, USA
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DeMarree KG, Naragon-Gainey K, Giancola A. Decentering constructs predict experience and tolerance of pain: evidence from a cold pressor study / Constructos relacionados con el descentramiento predicen la experiencia y la tolerancia al dolor: evidencia obtenida mediante la prueba del frío. INTERNATIONAL JOURNAL OF SOCIAL PSYCHOLOGY 2019; 34:535-562. [PMID: 32982002 DOI: 10.1080/02134748.2019.1639344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Decentering is a detached, observer perspective on one's current mental contents. Recent work has identified two potential aspects of decentering, Observer Perspective (OP) and Reduced Struggle (RS), that independently predict the effects of decentering. Specifically, both OP and RS predict reduced psychological distress in response to negative affect, with some variability in predictive utility across outcomes. In this study, we sought to extend previous work by examining OP and RS as predictors of responses to an external source of distress, a painful stimulus. Participants completed measures of decentering, followed by a cold pressor task for up to 4 minutes. We recorded time that participants were able to withstand the cold water bath and the intensity of the pain experienced. We found that both OP and RS predicted participants' pain tolerance and pain intensity, but that only RS did so uniquely. Results are discussed with respect to theory on decentering.
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Addicott MA, Daughters SB, Strauman TJ, Appelbaum LG. Distress tolerance to auditory feedback and functional connectivity with the auditory cortex. Psychiatry Res Neuroimaging 2018; 282:1-10. [PMID: 30384144 PMCID: PMC6289788 DOI: 10.1016/j.pscychresns.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 01/22/2023]
Abstract
Distress tolerance is the capacity to withstand negative affective states in pursuit of a goal. Low distress tolerance may bias an individual to avoid or escape experiences that induce affective distress, but the neural mechanisms underlying the bottom-up generation of distress and its relationship to behavioral avoidance are poorly understood. During a neuroimaging scan, healthy participants completed a mental arithmetic task with easy and distress phases, which differed in cognitive demands and positive versus negative auditory feedback. Then, participants were given the opportunity to continue playing the distress phase for a financial bonus and were allowed to quit at any time. The persistence duration was the measure of distress tolerance. The easy and distress phases activated auditory cortices and fronto-parietal regions. A task-based functional connectivity analysis using the left secondary auditory cortex (i.e., planum temporale) as the seed region revealed stronger connectivity to fronto-parietal regions and anterior insula during the distress phase. The distress-related connectivity between the seed region and the left anterior insula was negatively correlated with distress tolerance. The results provide initial evidence of the role of the anterior insula as a mediating link between the bottom-up generation of affective distress and top-down behavioral avoidance of distress.
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Affiliation(s)
- Merideth A Addicott
- Department of Psychiatry, University of Arkansas for Medical Science, 4301 W. Markham St., #843, Little Rock, AR 72205, USA.
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27516, USA
| | - Timothy J Strauman
- Department of Psychology and Neuroscience, Duke University, Durham, NC 27708, USA
| | - L Gregory Appelbaum
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27710, USA
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Shires A, Sharpe L, Newton John TRO. The relative efficacy of mindfulness versus distraction: The moderating role of attentional bias. Eur J Pain 2018; 23:727-738. [DOI: 10.1002/ejp.1340] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Alice Shires
- School of Psychology University of Sydney Sydney New South Wales Australia
- Clinical Psychology Department, Graduate School of HealthUniversity of Technology Sydney New South Wales Australia
| | - Louise Sharpe
- School of Psychology University of Sydney Sydney New South Wales Australia
| | - Toby R. O. Newton John
- Clinical Psychology Department, Graduate School of HealthUniversity of Technology Sydney New South Wales Australia
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35
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Wang T, Yang LL, Yang Z, Huang XT. Imagining My Painful Hand Is Not Mine: Self-Distancing Relieves Experimental Acute Pain Induced by a Cold Pressor Task. THE JOURNAL OF PAIN 2018; 20:358-365. [PMID: 30339929 DOI: 10.1016/j.jpain.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 05/23/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022]
Abstract
Self-distancing has been shown to alleviate emotional pain and to have potential efficacy for treating chronic pain and imagined acute pain, relative to self-immersing. This study examined the efficacy of self-distancing in relieving acute physical pain caused by a cold pressor task (CPT) in healthy adults. A total of 65 undergraduates were assigned pseudorandomly to 1 of 3 groups: 1) a self-distancing group, in which participants were instructed to "take a step back" to simulate their current painful experience as an observer, 2) a self-immersed group, in which participants' current painful experience was stimulated from the egocentric perspective, and 3) a control group, in which participants coped with pains in their spontaneous ways. Three key sessions were included in the present experiment: the pretest CPT, the perspective training (instead of rest in the control group), and the posttest CPT. The participants were to adopt the designated perspective only during the posttest CPT. The results showed that 1) maintaining a self-distanced perspective while experiencing pain decreased the sensation of pain, relative to the self-immersed group and the control group; and (2) compared with the control group, maintaining a self-immersed perspective neither alleviated nor aggravated the pain. This result supports that self-distancing could relieve the acute pain induced by CPT. Perspective: This study presents a brief effective psychological intervention to manage acute pain. This result could potentially have clinical and everyday importance.
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Affiliation(s)
- Tong Wang
- School of Psychology, Shaanxi Normal University, Xían, China
| | - Lian Lian Yang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhou Yang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Xi Ting Huang
- Faculty of Psychology, Southwest University, Chongqing, China.
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36
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Schumer MC, Lindsay EK, Creswell JD. Brief mindfulness training for negative affectivity: A systematic review and meta-analysis. J Consult Clin Psychol 2018; 86:569-583. [PMID: 29939051 PMCID: PMC6441958 DOI: 10.1037/ccp0000324] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Over the last 10 years, there has been a dramatic increase in published randomized controlled trials (RCTs) of brief mindfulness training (from single-session inductions to multisession interventions lasting up to 2 weeks), with some preliminary indications that these training programs may improve mental health outcomes, such as negative affectivity. This meta-analysis aimed to evaluate whether brief mindfulness training reliably reduces negative affectivity. METHOD PubMed, PsycINFO, and the Mindfulness Research Monthly Newsletter were systematically searched for brief mindfulness intervention RCTs assessing negative affectivity outcomes (e.g., depression, rumination, anxiety, stress). Sixty-five RCTs, including 5,489 participants predominantly without experience in meditation (64.64% female, mean age = 24.62), qualified for the meta-analytic review. RESULTS The meta-analysis revealed a small but significant effect of brief mindfulness training on reducing negative affectivity compared to control programs (g = .21, p < .001). The overall effect size was significantly moderated by participant characteristics: community samples (g = .41, p < .001) produced larger training effects compared to student samples (g = .14, p = .001; Qbetween p = .03). No significant effect size differences were found between clinical and nonclinical samples. However, when accounting for publication bias, the overall effect size of brief mindfulness training programs on negative affectivity was significantly reduced (g = .04). CONCLUSIONS Brief mindfulness training programs are increasingly popular approaches for reducing negative affectivity. This meta-analysis indicates that brief mindfulness training modestly reduces negative affectivity. Quantitative analyses indicated the presence of publication bias (i.e., unpublished null effect studies), highlighting the need to continue rigorous evaluation of brief mindfulness interventions. (PsycINFO Database Record
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Affiliation(s)
- Maya C. Schumer
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095
| | - Emily K. Lindsay
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15213
| | - J. David Creswell
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, 15213
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Abstract
OBJECTIVES It is not known whether psychosocial chronic pain treatments produce benefits through the unique mechanisms specified by theory. Fundamental to gaining an accurate understanding of this issue is to first determine whether the most widely used process measures assess unique constructs and predict unique variance in pain outcomes. This study examined the associations between the Pain Catastrophizing Scale (PCS), Five-Facet Mindfulness Questionnaire (FFMQ-SF), and the Chronic Pain Acceptance Questionnaire (CPAQ-8), and determined their unique contributions to the prediction of pain intensity, pain interference, and depression. METHODS A cross-sectional study was conducted with undergraduate students (N=260) reporting chronic or intermittent pain. Correlations, regression models, and multiple mediation models were performed. Relevant covariates were included. RESULTS The PCS, FFMQ-SF scales, and CPAQ-8 were correlated in mostly expected directions, but not so highly as to indicate redundancy. The PCS significantly predicted pain intensity, interference, and depression. The FFMQ-SF Observing and Describing scales predicted pain intensity; Nonreactivity and Nonjudging significantly predicted interference and depression, respectively. The CPAQ-8 was not a significant predictor in any of the regression models. The PCS was a comparatively stronger mediator than the FFMQ-SF scales in the intensity to interference, and intensity to depression mediation models. DISCUSSION The findings indicate that pain catastrophizing, mindfulness, and pain acceptance are related, but unique constructs. The PCS and select FFMQ-SF scales were uniquely associated with the criterion measures. However, the PCS emerged as the most robust process, highlighting the importance of targeting this cognitive domain in streamlining pain treatments to optimize outcome.
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Zhou J, Peng P, Xie X. Prevalence of Pain and Effects of a Brief Mindfulness-Based Intervention on Chinese Community-Dwelling Older Adults with Chronic Pain. J Community Health Nurs 2018; 35:19-27. [PMID: 29323939 DOI: 10.1080/07370016.2018.1404831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Jingxuan Zhou
- Specialized Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Ping Peng
- Specialized Medical Service Center, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xiaohua Xie
- Department of Nursing, The Second People’s Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
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Swearing as a response to pain: A cross-cultural comparison of British and Japanese participants. Scand J Pain 2017; 17:267-272. [PMID: 29229213 DOI: 10.1016/j.sjpain.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 06/12/2017] [Accepted: 07/07/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Research suggests swearing can moderate pain perception. The present study assessed whether changes in pain perception due to swearing reflect a "scripting" effect by comparing swearing as a response to pain in native English and Japanese speakers. Cognitive psychology denotes a 'script' to be a sequence of learnt behaviours expected for given situations. Japanese participants were included as they rarely, if ever, swear as a response to pain and therefore do not possess an available script for swearing in the context of pain. It was hypothesised that Japanese participants would demonstrate less tolerance and more sensitivity to pain than English participants, and - due to a lack of an available script of swearing in response to pain - that Japanese participants would not experience swearword mediated hypoalgesia. METHODS Fifty-six native English (mean age=23 years) and 39 Japanese (mean age=21) speakers completed a cold-pressor task whilst repeating either a swear on control word. A 2 (culture; Japanese, British)×2 (word; swear; non-swear) design explored whether Japanese participants showed the same increase in pain tolerance and experienced similar levels of perceived pain when a swearing intervention was used as British participants. Pain tolerance was assessed by the number of seconds participants could endure of cold-pressor exposure and self-report pain measurements. Levels of perceived pain were assessed using a 120-mm horizontal visual analogue scale anchored by descriptors in the participant's native language of "no pain" (left) and "terrible pain" (right). The participant was asked to mark a 10mm vertical line to indicate overall pain intensity. The score was measured from the zero anchor to the participant's mark. RESULTS Japanese participants reported higher levels of pain (p<0.005) and displayed lower pain tolerance than British participants (p<0.05). Pain tolerance increased in swearers regardless of cultural background (p<0.001) and no interaction was found between word group and culture (p=0.96), thereby suggesting that swearing had no differential effect related to the cultural group of the participant. CONCLUSIONS The results replicate previous findings that swearing increases pain tolerance and that individuals from an Asian ethnic background experience greater levels of perceived pain than those from a Caucasian ethnic background. However, these results do not support the idea of pain perception modification due to a "scripting" effect. This is evidenced as swearword mediated hypoalgesia occurs irrespective of participant cultural background. Rather, it is suggested that modulation of pain perception may occur through activation of descending inhibitory neural pain mechanisms. IMPLICATIONS As swearing can increase pain tolerance in both Japanese and British people, it may be suggested that swearword mediated hypoalgesia is a universal phenomenon that transcends socio-cultural learnt behaviours. Furthermore, swearing could be encouraged as an intervention to help people cope with acute painful stimuli.
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Smith KE, Norman GJ. Brief relaxation training is not sufficient to alter tolerance to experimental pain in novices. PLoS One 2017; 12:e0177228. [PMID: 28493923 PMCID: PMC5426711 DOI: 10.1371/journal.pone.0177228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/24/2017] [Indexed: 11/23/2022] Open
Abstract
Relaxation techniques, such as deep breathing and muscle relaxation, are aspects common to most forms of mindfulness training. There is now an abundance of research demonstrating that mindfulness training has beneficial effects across a wide range of clinical conditions, making it an important tool for clinical intervention. One area of extensive research is on the beneficial effects of mindfulness on experiences of pain. However, the mechanisms of these effects are still not well understood. One hypothesis is that the relaxation components of mindfulness training, through alterations in breathing and muscle tension, leads to changes in parasympathetic and sympathetic nervous system functioning which influences pain circuits. The current study seeks to examine how two of the relaxation subcomponents of mindfulness training, deep breathing and muscle relaxation, influence experiences of pain in healthy individuals. Participants were randomized to either a 10 minute deep breathing, progressive muscle relaxation, or control condition after which they were exposed to a cold pain task. Throughout the experiment, measures of parasympathetic and sympathetic nervous system activity were collected to assess how deep breathing and progressive muscle relaxation alter physiological responses, and if these changes moderate any effects of these interventions on responses to pain. There were no differences in participants’ pain tolerances or self-reported pain ratings during the cold pain task or in participants’ physiological responses to the task. Additionally, individual differences in physiological functioning were not related to differences in pain tolerance or pain ratings. Overall this study suggests that the mechanisms through which mindfulness exerts its effects on pain are more complex than merely through physiological changes brought about by altering breathing or muscle tension. This indicates a need for more research examining the specific subcomponents of mindfulness, and how these subcomponents might be acting, to better understand their utility as a clinical treatment.
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Affiliation(s)
- Karen E. Smith
- Department of Psychology, Integrative Neuroscience Area, University of Chicago, Chicago, Illinois, United States of America
- * E-mail:
| | - Greg J. Norman
- Department of Psychology, Integrative Neuroscience Area, University of Chicago, Chicago, Illinois, United States of America
- Grossman Institute for Neuroscience, University of Chicago, Chicago, Illinois, United States of America
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Shorey RC, Strauss C, Elmquist J, Anderson S, Cornelius TL, Stuart GL. Distress Tolerance and Intimate Partner Violence among Men in Substance Use Treatment. JOURNAL OF FAMILY VIOLENCE 2017; 32:317-324. [PMID: 28366983 PMCID: PMC5373090 DOI: 10.1007/s10896-016-9843-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Intimate partner violence (IPV) is overrepresented among men in substance use treatment. Individuals who relapse following substance use treatment report greater IPV perpetration relative to individuals who remain remitted. In addition, distress tolerance has been shown to be an important treatment target in substance use treatment, with distress tolerance predicting relapse following treatment. However, we are unaware of any research that has examined the relationship between distress tolerance and IPV among men in substance use treatment, which may hold important treatment implications. The current study therefore examined this relationship in a sample of men in substance use treatment (N = 138). Results demonstrated that distress tolerance was negatively associated with physical and psychological IPV perpetration. After controlling for age and substance use and problems, distress tolerance remained associated with psychological, but not physical, IPV perpetration. These findings suggest that distress tolerance may be an important component of treatments for IPV, particularly for psychological aggression. Substance use treatment programs that target distress tolerance may concurrently reduce the risk for relapse to substance use and IPV perpetration.
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Burnett D, Phillips G, Tashani OA. The Effect of Brief Mindfulness Meditation on Cold-Pressor Induced Pain Responses in Healthy Adults. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/pst.2017.52002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Howarth A, Perkins-Porras L, Copland C, Ussher M. Views on a brief mindfulness intervention among patients with long-term illness. BMC Psychol 2016; 4:56. [PMID: 27842610 PMCID: PMC5109661 DOI: 10.1186/s40359-016-0163-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/03/2016] [Indexed: 11/18/2022] Open
Abstract
Background Chronic illness is the leading cause of death in the UK and worldwide. Psychological therapies to support self-management have been shown to play an important role in helping those with chronic illness cope; more recently, the therapeutic benefits of mindfulness approaches have become evident for managing depression and other distressing emotions. Brief guided mindfulness interventions, are more convenient than intensive traditional programmes requiring regular attendance but have been less explored. This study assessed views on a brief (i.e., 10 min) mindfulness intervention for those with specific long-term illnesses. Methods Semi-structured interviews and focus groups were conducted with chronic illness patient groups (i.e., chronic obstructive pulmonary disease, chronic pain and cardiovascular disease), designed to capture the acceptability and feasibility of the intervention. The interviews were conducted after use of a mindfulness based audio in clinic and, one week later, after use in the patient’s own environment. Interviews were recorded, transcribed and analysed using thematic analysis. Results In total, a combination of 18 interviews and focus groups were conducted among 14 patients. Recruitment was most successful with chronic pain patients. All patients reported benefits such as feelings of relaxation and improved coping with symptoms. While the wording and content of the audio were generally well received, it was suggested that the length could be increased, as it felt rushed, and that more guidance about the purpose of mindfulness, and when to use it, was needed. Conclusions A brief mindfulness intervention was well accepted among patients with long-term illness. The intervention may benefit by being lengthened and by offering further guidance on its use. Electronic supplementary material The online version of this article (doi:10.1186/s40359-016-0163-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ana Howarth
- Population Health Research Institute, St George's University of London, London, UK.
| | - Linda Perkins-Porras
- Institute of Medical and Biomedical Education, St George's University of London, London, UK
| | - Claire Copland
- Chronic Pain Service, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George's University of London, London, UK
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Bergeron CM, Dandeneau S. Implicitly Activating Mindfulness Promotes Positive Responses Following an Ego Threat. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2016. [DOI: 10.1521/jscp.2016.35.7.551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Howarth A, Perkins-Porras L, Smith JG, Subramaniam J, Copland C, Hurley M, Beith I, Riaz M, Ussher M. Pilot study evaluating a brief mindfulness intervention for those with chronic pain: study protocol for a randomized controlled trial. Trials 2016; 17:273. [PMID: 27255280 PMCID: PMC4890280 DOI: 10.1186/s13063-016-1405-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Accepted: 05/17/2016] [Indexed: 12/03/2022] Open
Abstract
Background The burden of chronic pain is a major challenge, impacting the quality of life of patients. Intensive programmes of mindfulness-based therapy can help patients to cope with chronic pain but can be time consuming and require a trained specialist to implement. The self-management model of care is now integral to the care of patients with chronic pain; home-based interventions can be very acceptable, making a compelling argument for investigating brief, self-management interventions. The aim of this study is two-fold: to assess the immediate effects of a brief self-help mindfulness intervention for coping with chronic pain and to assess the feasibility of conducting a definitive randomized controlled trial to determine the effectiveness of such an intervention. Methods/Design A randomized controlled pilot study will be conducted to evaluate a brief mindfulness intervention for those with chronic pain. Ninety chronic pain patients who attend hospital outpatient clinics will be recruited and allocated randomly to either the control or treatment group on a 1:1 basis using the computer-generated list of random numbers. The treatment group receives mindfulness audios and the control group receives audios of readings from a non-fiction book, all of which are 15 minutes in length. Immediate effects of the intervention are assessed with brief psychological measures immediately before and after audio use. Mindfulness, mood, health-related quality of life, pain catastrophizing and experience of the intervention are assessed with standardized measures, brief ratings and brief telephone follow-ups, at baseline and after one week and one month. Feasibility is assessed by estimation of effect sizes for outcomes, patient adherence and experience, and appraisal of resource allocation in provision of the intervention. Discussion This trial will assess whether a brief mindfulness-based intervention is effective for immediately reducing perceived distress and pain with the side effect of increasing relaxation in chronic pain patients and will determine the feasibility of conducting a definitive randomized controlled trial. Patient recruitment began in January 2015 and is due to be completed in June 2016. Trial registration ISRCTN61538090 Registered 20 April 2015 Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1405-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ana Howarth
- Population Health Research Institute, St George's, University of London, London, UK.
| | - Linda Perkins-Porras
- Institute of Medical and Biomedical Education, St George's, University of London, London, UK
| | - Jared G Smith
- Population Health Research Institute, St George's, University of London, London, UK
| | - Jeevakan Subramaniam
- Population Health Research Institute, St George's, University of London, London, UK
| | - Claire Copland
- Chronic Pain Service, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - Mike Hurley
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
| | - Iain Beith
- Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
| | - Muhammad Riaz
- Population Health Research Institute, St George's, University of London, London, UK
| | - Michael Ussher
- Population Health Research Institute, St George's, University of London, London, UK
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Mindfulness-based stress reduction (MBSR) enhances distress tolerance and resilience through changes in mindfulness. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.mhp.2016.01.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Menezes CB, Pereira MG, Mocaiber I, Bizarro L. Brief Meditation and the Interaction between Emotional Interference and Anxiety. PSICOLOGIA: TEORIA E PESQUISA 2016. [DOI: 10.1590/0102-3772e322216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
ABSTRACT This pilot study assessed the effects of a five day focused meditation training on the interplay between emotional interference and anxiety in a non clinical sample randomized into two groups (experimental=13; control=18). Emotional interference was indexed comparing the reaction times in an attention span task with negative or neutral distracting images. Anxiety experienced during the task was also assessed through self-report. Only in the control group higher anxiety levels interacted with greater emotional interference and a worse evaluation of valence and arousal of emotional images. These preliminary findings suggest that meditation may help modulating anxiety effects on bias to negative stimuli, and that even a short training may facilitate self-regulatory processes.
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Mindfulness-based Stress Reduction as a Promising Intervention for Amelioration of Premenstrual Dysphoric Disorder Symptoms. Mindfulness (N Y) 2015; 6:1292-1302. [PMID: 26594254 DOI: 10.1007/s12671-015-0397-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The association between state attachment security and state Mindfulness. PLoS One 2015; 10:e0116779. [PMID: 25786134 PMCID: PMC4364742 DOI: 10.1371/journal.pone.0116779] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 12/14/2014] [Indexed: 11/25/2022] Open
Abstract
Recent research suggests that attachment and mindfulness are related, though the nature of this association is unclear. Here we present two studies examining whether there is a causal relationship between state attachment and state mindfulness. Study 1 investigated the effects of experimentally increasing state mindfulness on state attachment security. State mindfulness was successfully enhanced, but this led to no change in state attachment security. Study 2 investigated the effects of experimentally enhancing state attachment security on state mindfulness. State attachment security was successfully enhanced, but this did not lead to any change in state mindfulness. These findings suggest that there is not a direct, immediate causal relationship between state attachment and state mindfulness as a result of brief experimental manipulations. Future research should examine these associations in longer term interventions.
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Pots WTM, Meulenbeek PAM, Veehof MM, Klungers J, Bohlmeijer ET. The efficacy of mindfulness-based cognitive therapy as a public mental health intervention for adults with mild to moderate depressive symptomatology: a randomized controlled trial. PLoS One 2014; 9:e109789. [PMID: 25333885 PMCID: PMC4198116 DOI: 10.1371/journal.pone.0109789] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 09/06/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Although there has been growing evidence for the efficacy of mindfulness-based cognitive therapy (MBCT) for different clinical populations, its effectiveness as a public mental health intervention has not been studied. The present study evaluates a community-based MBCT intervention for adults with mild to moderate depressive symptomatology in a large multi-site, pragmatic randomized controlled trial. METHOD The participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the MBCT intervention (n = 76) or to a waiting list control group (n = 75). Participants completed measures before and after the intervention. Participants in the experimental condition also completed these measures at a 3-month follow-up. RESULTS In the experimental condition significant reductions in depression, anxiety, and experiential avoidance, and improvements in mindfulness and emotional- and psychological mental health were found, compared to the waiting list (effect sizes Cohen's d = 0.31-0.56). These effects were sustained at the 3-month follow-up. The likelihood of a clinically significant change in depressive symptoms was significantly higher for the MBCT group [odds ratio (OR) 3.026, p<0.01 at post-treatment; NNT = 5.10]. DISCUSSION MBCT as a public mental health intervention for adults with mild to moderate depressive symptoms seems effective and applicable in a natural setting. TRIAL REGISTRATION Nederlands Trial Register NTR2096.
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Affiliation(s)
- Wendy T. M. Pots
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
- Dimence, Community Mental Health Center, Almelo, the Netherlands
- * E-mail:
| | - Peter A. M. Meulenbeek
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
- GGNET, Community Mental Health Center, Warnsveld, the Netherlands
| | - Martine M. Veehof
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
| | - Jorinde Klungers
- GGNET, Community Mental Health Center, Warnsveld, the Netherlands
| | - Ernst T. Bohlmeijer
- University of Twente, Department of Psychology, Health & Technology, Enschede, the Netherlands
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