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OBJECTIVE: Mindfulness and pain catastrophizing are important constructs in pain research, and there are theoretical reasons for suspecting that measures of the 2 constructs should be related in predictable ways. The present study investigated the association of pain catastrophizing (Pain Catastrophizing Scale) with mindfulness (Five Facet Mindfulness Questionnaire). The Penn State Worry Questionnaire was included to control for confounding of worry; the influence of demographics was explored.METHODS: The participants were 214 undergraduates, who were administered questionnaires via the Internet. Analyses assessed relationships after correcting for attenuation.
RESULTS: The mindfulness scales had intercorrelations with catastrophizing ranging from -0.23 to 0.13; the Non-Judging, Non-Reactivity, and Acting with Awareness mindfulness scales correlated significantly with catastrophizing. However, worry was better correlated (r=0.35) with catastrophizing, and the mindfulness scales were not significantly related to catastrophizing after controlling for worry. Mindfulness scales were significant predictors (P=0.018) of catastrophizing scores in a single-indicator latent variable analysis, and 1 mindfulness scale (Non-Reactivity) contributed uniquely (P=0.006) to prediction. None of the mindfulness scales significantly predicted catastrophizing scores when worry was controlled, but the path from worry to catastrophizing was significant (P=0.048). Sex differences in catastrophizing scores were explained by sex differences on the worry scale (P<0.001).
DISCUSSION: These findings suggest that it is important to assess more general cognitive-emotional constructs, such as worry, when making inferences about the influence of mindfulness or changes in mindfulness upon catastrophic thinking in response to pain.
OBJECTIVE:This pilot study reports the findings of a randomized controlled trial (RCT) investigating the feasibility, tolerability, acceptability, and initial estimates of efficacy of mindfulness-based cognitive therapy (MBCT) compared to a delayed treatment (DT) control for headache pain. It was hypothesized that MBCT would be a viable treatment approach and that compared to DT, would elicit significant improvement in primary headache pain-related outcomes and secondary cognitive-related outcomes.
MATERIALS AND METHODS:
RCT methodology was employed and multivariate analysis of variance models were conducted on daily headache diary data and preassessment and postassessment data for the intent-to-treat sample (N=36), and on the completer sample (N=24).
RESULTS:
Patient flow data and standardized measures found MBCT for headache pain to be feasible, tolerable, and acceptable to participants. Intent-to-treat analyses showed that compared to DT, MBCT patients reported significantly greater improvement in self-efficacy (P=0.02, d=0.82) and pain acceptance (P=0.02, d=0.82). Results of the completer analyses produced a similar pattern of findings; additionally, compared to DT, MBCT completers reported significantly improved pain interference (P<0.01, d=-1.29) and pain catastrophizing (P=0.03, d=-0.94). Change in daily headache diary outcomes was not significantly different between groups (P's>0.05, d's≤-0.24).
DISCUSSION:
This study empirically examined MBCT for the treatment of headache pain. Results indicated that MBCT is a feasible, tolerable, acceptable, and potentially efficacious intervention for patients with headache pain. This study provides a research base for future RCTs comparing MBCT to attention control, and future comparative effectiveness studies of MBCT and cognitive-behavioral therapy.