Mindfulness-Based Stress Reduction Alleviates Stress and Depression in Adults with Chronic Pain: A Randomized Controlled Trial
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The primary aim of this study was to evaluate the effectiveness of Mindfulness-Based Stress Reduction (MBSR) in improving attention and pain-related outcomes, using a randomized controlled trial. Secondary aims included evaluating changes in mindfulness and pain acceptance following MBSR training and their role in improving outcomes, exploring the role of homework adherence in enhanced outcomes, and assessing stability of improvements long-term at 3-months follow up. Forty-nine adults with chronic pain between 18 and 80 years of age were randomized to an 8-week MBSR group or a Waitlist Control (WC) group that was then crossed over into the MBSR treatment. Outcome measures included pain intensity, pain disability, depression, anxiety, stress, mindfulness, pain acceptance, and performance on a change blindness task. Measures were administered prior to treatment, following the wait period for the WC group, following MBSR treatment, and 3-months subsequent to MBSR treatment completion. It was hypothesized that the MBSR group would demonstrate significant improvements in these outcomes, with the exception of pain severity, following treatment relative to the waitlist control group and that these benefits would be maintained at follow up. Linear regression analyses using changes scores of the outcomes revealed significantly greater reductions from pre-to-post treatment in the MBSR group compared to the WC group in depression and stress (ps < .05), and increases in mindfulness (p < .01). Multiple linear regression analyses using the entire sample demonstrated that increases in mindfulness significantly predicted decreases in depression (p < .05) and stress (p < .01) and increases in pain acceptance was significantly predictive of decreases in pain disability (p < .05). Significant correlations were obtained between the number of days engaging in practice and stress, pain acceptance, and attention. Benefits observed at post-treatment were maintained at 3-months follow up. Results suggest that mindfulness-based approaches can be integrated in pain clinics to facilitate patient recovery by reducing emotional distress.