Top

Mindfulness

Gepubliceerd in:

16-12-2022 | ORIGINAL PAPER

The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia

Auteurs: Eric L. Garland, R. Lynae Roberts, Adam W. Hanley, Fadel Zeidan, Francis J. Keefe

Gepubliceerd in: Mindfulness | Uitgave 1/2023

Abstract

Objectives

Mindfulness is theorized to decrease the affective amplification of chronic pain by facilitating a shift from emotionally-laden, catastrophic pain appraisals of nociceptive input to reappraising chronic pain as an innocuous sensory signal that does not signify harm. Understanding of these hypothetical psychological mechanisms of mindfulness-based analgesia has been limited by a lack of direct measures. We conducted a series of psychometric and experimental studies to develop and validate the Mindful Reappraisal of Pain Sensations Scale (MPRS).

Method

After item generation, we conducted exploratory and confirmatory factor analyses of the MRPS in samples of opioid-treated chronic pain patients both before (n = 450; n = 90) and after (n = 222) participating in Mindfulness-Oriented Recovery Enhancement (MORE). We then examined the convergent and divergent validity of the MRPS. Finally, in data from a randomized clinical trial (n = 250), the MRPS was tested as a mediator of the effects of MORE on reducing chronic pain severity.

Results

Exploratory and confirmatory factor analyses demonstrated the single-factor structure of the MRPS. The MRPS also evidenced convergent and divergent validity. Mindfulness training through MORE significantly increased MRPS scores relative to supportive psychotherapy (F_4,425.03 = 16.15, p < .001). Changes in MRPS scores statistically mediated the effect of MORE on reducing chronic pain severity through 9-month follow-up.

Conclusions

Taken together, these studies demonstrate that the MRPS is a psychometrically sound and valid measure of novel analgesic mechanisms of mindfulness including attentional disengagement from affective pain appraisals and interoceptive exposure to pain sensations.

vorige artikel Changes in Self-Location During the Practice of Mindfulness Meditation in Novices

volgende artikel Trait Mindfulness is Associated with Self-Disclosure and Responsiveness During Social Interactions with New Acquaintances

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504CrossRef

Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246. https://doi.org/10.1037/0033-2909.107.2.238

Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nd Ed.). Guilford.

Browne, M. W., & Cudeck, R. (1992). Alternative ways of assessing model fit. Sociological Methods & Research, 21(2), 230–258. https://doi.org/10.1177/0049124192021002005

Busse, J. W., Wang, L., Kamaleldin, M., Craigie, S., Riva, J. J., Montoya, L., Mulla, S. M., Lopes, L. C., Vogel, N., Chen, E., Kirmayr, K., De Oliveira, K., Olivieri, L., Kaushal, A., Chaparro, L. E., Oyberman, I., Agarwal, A., Couban, R., Tsoi, L., … Guyatt, G. H. (2018). Opioids for chronic noncancer pain: A systematic review and meta-analysis. JAMA, 320(23), 2448–2460. https://doi.org/10.1001/jama.2018.18472

Cayoun, B., Simmons, A., & Shires, A. (2020). Immediate and lasting chronic pain reduction following a brief self-implemented mindfulness-based interoceptive exposure task: A pilot study. Mindfulness, 11(1), 112–124. https://doi.org/10.1007/s12671-017-0823-xCrossRef

Cherkin, D. C., Sherman, K. J., Balderson, B. H., Cook, A. J., Anderson, M. L., Hawkes, R. J., Hansen, K. E., & Turner, J. A. (2016). Effect of Mindfulness-Based Stress Reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: A randomized clinical trial. JAMA, 315(12), 1240–1249. https://doi.org/10.1001/jama.2016.2323

Clauwaert, A., Torta, D. M., Danneels, L., & Van Damme, S. (2018). Attentional modulation of somatosensory processing during the anticipation of movements accompanying pain: An event-related potential study. The Journal of Pain, 19(2), 219–227. https://doi.org/10.1016/j.jpain.2017.10.008

Craske, M. G., Wolitzky-Taylor, K. B., Labus, J., Wu, S., Frese, M., Mayer, E. A., & Naliboff, B. D. (2011). A cognitive-behavioral treatment for irritable bowel syndrome using interoceptive exposure to visceral sensations. Behaviour Research and Therapy, 49(6), 413–421. https://doi.org/10.1016/j.brat.2011.04.001CrossRef

de C Williams, A. C., Fisher, E., Hearn, L., & Eccleston, C. (2020). Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews, 8. https://doi.org/10.1002/14651858.CD007407.pub4

Durnez, W., & Van Damme, S. (2015). Trying to fix a painful problem: The impact of pain control attempts on the attentional prioritization of a threatened body location. The Journal of Pain, 16(2), 135–143. https://doi.org/10.1016/j.jpain.2014.10.012

Dyczkowski, M. S. (1987). The doctrine of vibration: An analysis of the doctrines and practices associated with Kashmir Shaivism. SUNY Press.

Flink, I. K., Nicholas, M. K., Boersma, K., & Linton, S. J. (2009). Reducing the threat value of chronic pain: A preliminary replicated single-case study of interoceptive exposure versus distraction in six individuals with chronic back pain. Behaviour Research and Therapy, 47(8), 721–728. https://doi.org/10.1016/j.brat.2009.05.003CrossRef

Garland, E. L. (2013). Mindfulness-oriented recovery enhancement for addiction, stress, and pain. NASW Press.

Garland, E. L. (2020). Psychosocial intervention and the reward system in pain and opioid misuse: New opportunities and directions. Pain, 161(12), 2659–2666. https://doi.org/10.1097/j.pain.0000000000001988CrossRef

Garland, E. L., Gaylord, S. A., Palsson, O., Faurot, K., Mann, J. D., & Whitehead, W. E. (2012). Therapeutic mechanisms of a mindfulness-based treatment for IBS: Effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. Journal of Behavioral Medicine, 35(6), 591–602. https://doi.org/10.1007/s10865-011-9391-z

Garland, E. L., Manusov, E. G., Froeliger, B., Kelly, A., Williams, J. M., & Howard, M. O. (2014). Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: Results from an early-stage randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(3), 448–459. https://doi.org/10.1037/a0035798

Garland, E. L., Hanley, A. W., Riquino, M. R., Reese, S. E., Baker, A. K., Salas, K., Yack, B. P., Bedford, C. E., Bryan, M. A., Atchley, R., Nakamura, Y., Froeliger, B., & Howard, M. O. (2019). Mindfulness-oriented recovery enhancement reduces opioid misuse risk via analgesic and positive psychological mechanisms: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 87(10), 927–940. https://doi.org/10.1037/ccp0000390CrossRef

Garland, E. L., Hanley, A. W., Nakamura, Y., Barrett, J. W., Baker, A. K., Reese, S. E., Riquino, M. R., Froeliger, B., & Donaldson, G. W. (2022). Mindfulness-Oriented Recovery Enhancement vs supportive group therapy for co-occurring opioid misuse and chronic pain in primary care: A randomized clinical trial. JAMA Internal Medicine, 182(4), 407–417. https://doi.org/10.1001/jamainternmed.2022.0033

Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348

Hanley, A. W., & Garland, E. L. (2019). Mapping the affective dimension of embodiment with the sensation manikin: Validation among chronic pain patients and modification by mindfulness-oriented recovery enhancement. Psychosomatic Medicine, 81(7), 612–621. https://doi.org/10.1097/PSY.0000000000000725

Hanley, A. W., Gililland, J., & Garland, E. L. (2021). To be mindful of the breath or pain: Comparing two brief preoperative mindfulness techniques for total joint arthroplasty patients. Journal of Consulting and Clinical Psychology, 89(7), 590–600. https://doi.org/10.1037/ccp0000657

Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., Schnitzer, T. J., & Apkarian, A. V. (2013). Shape shifting pain: Chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751–2768. https://doi.org/10.1093/brain/awt211

Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., Colaiaco, B., Maher, A. R., Shanman, R. M., Sorbero, M. E., & Maglione, M. A. (2017). Mindfulness meditation for chronic pain: Systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. https://doi.org/10.1007/s12160-016-9844-2CrossRef

Hobart, J., & Cano, S. (2009). Improving the evaluation of therapeutic interventions in multiple sclerosis: The role of new psychometric methods. Health Technology Assessment, 13(12). https://doi.org/10.3310/hta13120

Hu, L.-T., & Bentler, P. M. (1995). Evaluating model fit. In R. H. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 76–99). Sage.

Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118CrossRef

Jinich-Diamant, A., Garland, E., Baumgartner, J., Gonzalez, N., Riegner, G., Birenbaum, J., Case, L., & Zeidan, F. (2020). Neurophysiological mechanisms supporting mindfulness meditation–based pain relief: An updated review. Current Pain and Headache Reports, 24(10), 56. https://doi.org/10.1007/s11916-020-00890-8CrossRef

Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47. https://doi.org/10.1016/0163-8343(82)90026-3CrossRef

Kline, R. B. (2005). Principles and practice of structural equation modeling. Guilford.

Kuner, R., & Flor, H. (2017). Structural plasticity and reorganisation in chronic pain. Nature Reviews Neuroscience, 18(1), 20–30. https://doi.org/10.1038/nrn.2016.162CrossRef

Labrenz, F., Icenhour, A., Schlamann, M., Forsting, M., Bingel, U., & Elsenbruch, S. (2016). From Pavlov to pain: How predictability affects the anticipation and processing of visceral pain in a fear conditioning paradigm. NeuroImage, 130, 104–114. https://doi.org/10.1016/j.neuroimage.2016.01.064CrossRef

Leggett, L. E., Soril, L. J., Lorenzetti, D. L., Noseworthy, T., Steadman, R., Tiwana, S., & Clement, F. (2014). Radiofrequency ablation for chronic low back pain: A systematic review of randomized controlled trials. Pain Research and Management, 19(5), e146–e153. https://doi.org/10.1155/2014/834369CrossRef

Ludwig, D. S., & Kabat-Zinn, J. (2008). Mindfulness in Medicine. JAMA, 300(11), 1350–1352. https://doi.org/10.1001/jama.300.11.1350CrossRef

McClintock, A. S., McCarrick, S. M., Garland, E. L., Zeidan, F., & Zgierska, A. E. (2019). Brief mindfulness-based interventions for acute and chronic pain: A systematic review. The Journal of Alternative and Complementary Medicine, 25(3), 265–278. https://doi.org/10.1089/acm.2018.0351

Medvedev, O. N., & Siegert, R. J. (2022). Generalizability theory. In O. N. Medvedev, C. U. Krägeloh, R. J. Siegert, & N. N. Singh (Eds.), Handbook of Assessment in Mindfulness Research. Springer. https://doi.org/10.1007/978-3-030-77644-2_5-1

Mehling, W. E., Price, C., Daubenmier, J. J., Acree, M., Bartmess, E., & Stewart, A. (2012). The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS ONE, 7(11), e48230. https://doi.org/10.1371/journal.pone.0048230

Namgyal, D. T. (2006). Mahamudra: The Moonlight–Quintessence of Mind and Meditation. Simon and Schuster.

Nielsen, L., Riddle, M., King, J. W., Aklin, W. M., Chen, W., Clark, D., Collier, E., Czajkowski, S., Esposito, L., & Ferrer, R. (2018). The NIH Science of Behavior Change Program: Transforming the science through a focus on mechanisms of change. Behaviour Research and Therapy, 101, 3–11. https://doi.org/10.1016/j.brat.2017.07.002

Nyanaponika. (1998). Abhidhamma studies: Buddhist explorations of consciousness and time. Simon and Schuster.

Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63(1), 539–569. https://doi.org/10.1146/annurev-psych-120710-100452CrossRef

Pushparaj, H., Hoydonckx, Y., Mittal, N., Peng, P., Cohen, S. P., Cao, X., & Bhatia, A. (2021). A systematic review and meta-analysis of radiofrequency procedures on innervation to the shoulder joint for relieving chronic pain. European Journal of Pain, 25(5), 986–1011. https://doi.org/10.1002/ejp.1735CrossRef

Riegner, G., Posey, G., Oliva, V., Jung, Y., Mobley, W., & Zeidan, F. (2022). Disentangling self from pain: Mindfulness meditation-induced pain relief is driven by thalamic-default mode network decoupling. Pain. https://doi.org/10.1097/j.pain.0000000000002731

Rosenstiel, A. K., & Keefe, F. J. (1983). The use of coping strategies in chronic low back pain patients: Relationship to patient characteristics and current adjustment. Pain, 17(1), 33–44. https://doi.org/10.1016/0304-3959(83)90125-2CrossRef

Seminowicz, D. A., Burrowes, S. A., Kearson, A., Zhang, J., Krimmel, S. R., Samawi, L., Furman, A. J., Keaser, M. L., Gould, N. F., Magyari, T., White, L., Goloubeva, O., Goyal, M., Peterlin, B. L., & Haythornthwaite, J. A. (2020). Enhanced mindfulness based stress reduction (MBSR+) in episodic migraine: A randomized clinical trial with MRI outcomes. Pain, 161(8), 1837–1846. https://doi.org/10.1097/j.pain.0000000000001860CrossRef

Smith, S. L., & Langen, W. H. (2020). A systematic review of mindfulness practices for improving outcomes in chronic low back pain. International Journal of Yoga, 13(3), 177–182. https://doi.org/10.4103/ijoy.IJOY_4_20CrossRef

Steiger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioral Research, 25(2), 173–180. https://doi.org/10.1207/s15327906mbr2502_4

Strigo, I. A., Simmons, A. N., Matthews, S. C., Craig Bud, A. D., & Paulus, M. P. (2008). Increased affective bias revealed using experimental graded heat stimuli in young depressed adults: Evidence of “Emotional Allodynia.” Psychosomatic Medicine, 70(3), 338–344. https://doi.org/10.1097/PSY.0b013e3181656a48

Tabor, A., Keogh, E., & Eccleston, C. (2017). Embodied pain—Negotiating the boundaries of possible action. Pain, 158(6), 1007–1011. https://doi.org/10.1097/j.pain.0000000000000875

Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38(1), 1–10. https://doi.org/10.1007/BF02291170CrossRef

Van Damme, S., Bulcke, C. V., Van Den Berghe, L., Poppe, L., & Crombez, G. (2018). Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw? PeerJ, 6, e4310. https://doi.org/10.7717/peerj.4310

VandenBulcke, C., Van Damme, S., Durnez, W., & Crombez, G. (2013). The anticipation of pain at a specific location of the body prioritizes tactile stimuli at that location. Pain, 154(8), 1464–1468. https://doi.org/10.1016/j.pain.2013.05.009

Vowles, K. E., McCracken, L. M., McLeod, C., & Eccleston, C. (2008). The chronic pain acceptance questionnaire: Confirmatory factor analysis and identification of patient subgroups. Pain, 140(2), 284–291. https://doi.org/10.1016/j.pain.2008.08.012

Wiech, K. (2016). Deconstructing the sensation of pain: The influence of cognitive processes on pain perception. Science, 354(6312), 584–587. https://doi.org/10.1126/science.aaf8934CrossRef

Wiech, K., & Tracey, I. (2009). The influence of negative emotions on pain: Behavioral effects and neural mechanisms. NeuroImage, 47(3), 987–994. https://doi.org/10.1016/j.neuroimage.2009.05.059

Wiech, K., Vandekerckhove, J., Zaman, J., Tuerlinckx, F., Vlaeyen, J. W., & Tracey, I. (2014). Influence of prior information on pain involves biased perceptual decision-making. Current Biology, 24(15), R679–R681. https://doi.org/10.1016/j.cub.2014.06.022

Zeidan, F., & Vago, D. (2016). Mindfulness meditation–based pain relief: A mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114–127. https://doi.org/10.1111/nyas.13153CrossRef

Zeidan, F., Martucci, K. T., Kraft, R. A., Gordon, N. S., McHaffie, J. G., & Coghill, R. C. (2011). Brain mechanisms supporting the modulation of pain by mindfulness meditation. Journal of Neuroscience, 31(14), 5540–5548. https://doi.org/10.1523/JNEUROSCI.5791-10.2011

Zeidan, F., Grant, J. A., Brown, C. A., McHaffie, J. G., & Coghill, R. C. (2012). Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain. Neuroscience Letters, 520(2), 165–173. https://doi.org/10.1016/j.neulet.2012.03.082

Zeidan, F., Emerson, N. M., Farris, S. R., Ray, J. N., Jung, Y., McHaffie, J. G., & Coghill, R. C. (2015). Mindfulness meditation-based pain relief employs different neural mechanisms than placebo and sham mindfulness meditation-induced analgesia. Journal of Neuroscience, 35(46), 15307–15325. https://doi.org/10.1523/JNEUROSCI.2542-15.2015CrossRef

Titel: The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia
Auteurs: Eric L. Garland
R. Lynae Roberts
Adam W. Hanley
Fadel Zeidan
Francis J. Keefe
Publicatiedatum: 16-12-2022
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 1/2023
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-022-02034-y

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Objectives

Method

Results

Conclusions

Log in om toegang te krijgen

Andere artikelen Uitgave 1/2023

Linking Mothers’ Self-Compassion and Parenting Feelings to Their Child’s Behavior Problems

Efficacy of Mindfulness-Based Cognitive Therapy Compared to Diet Modification Alone for Dysphagia in Persons with Multiple Sclerosis

Exploring the Influence of a Mindfulness Intervention on the Experiences of Mothers with Infants in Neonatal Intensive Care Units

Nirbhay N. Singh: an Appreciation

Monica M. Jackman: Mindfulness for Preschool and Kindergarten: The OpenMind Program to Boost Social-Emotional Learning and Classroom Engagement. New Harbinger Publications, Inc., Oakland, CA, 2022, 280 pp

Reciprocal Associations Between Self-compassion and Eating Disorder Symptoms: an 8-month Longitudinal Study