Pain Catastrophizing and Mindfulness: Exploring Mechanisms of Change Associated with Participation in a Mindfulness-Based Stress Reduction Program in Diabetic Peripheral Neuropathy Patients

Diabetic peripheral neuropathy (DPN) affects up to half of those with type 2 diabetes mellitus. Chronic neuropathic pain, a common symptom of DPN, remains difficult to treat pharmacologically. Mindfulness-based stress reduction (MBSR) has demonstrated benefits in chronic pain populations and a recently completed randomized controlled trial demonstrated improved function among patients with DPN who completed the program. The present study used archival data from this recently completed trial, with 62 participants (Mean age = 59.7 years, SD = 8.8). It was predicted that improved function following MBSR training would be explained by increased mindfulness and a reduction of pain catastrophizing. Mediation analysis indicated that while mindfulness was a mediator, pain catastrophizing was not, when controlling for baseline scores. This suggests that MBSR may improve function through self-awareness and one's ability to engage in the present moment non-judgmentally, rather than through ones ability to control and reduce pain-related catastrophic cognitions.