The Mindful Reappraisal of Pain Scale (MRPS): Validation of a New Measure of Psychological Mechanisms of Mindfulness-Based Analgesia.
Eric L Garland, R Lynae Roberts, Adam W. Hanley, Fadel Zeidan, Francis J Keefe
Mindfulness 2023 DOI: 10.1007/s12671-022-02034-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Psychometric study with exploratory and confirmatory factor analyses, and mediation analysis from a randomized clinical trial Peer reviewed |
|---|---|
| Sample size | 450 |
| Population | Opioid-treated chronic pain patients |
| Intervention | Mindfulness-Oriented Recovery Enhancement (MORE) |
| Duration | 9-month follow-up |
| Topics | Meditation |
| Keywords | Chronic pain Decentering Interoceptive exposure Measurement Pain appraisal |
| Citations | 14 |
| Key findings | The Mindful Reappraisal of Pain Sensations Scale (MRPS) is a psychometrically sound measure that mediates the effect of mindfulness training on reducing chronic pain severity. |
Abstract
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). 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. 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 (F4,425.03 = 16.15, p < .001). Changes in MRPS scores statistically mediated the effect of MORE on reducing chronic pain severity through 9-month follow-up. 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.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 9
- The role of endogenous opioids in mindfulness and sham mindfulness-meditation for the direct alleviation of evoked chronic low back pain: a randomized clinical trial. Neuropsychopharmacology June 1, 2024
- Virtually delivered Mindfulness-Oriented Recovery Enhancement (MORE) reduces daily pain intensity in patients with lumbosacral radiculopathy: a randomized controlled trial. PAIN Reports April 1, 2024
- Mindfulness-Oriented Recovery Enhancement for Cancer Pain Relief: Pilot Randomized Controlled Trial. Journal of Pain and Symptom Management January 3, 2026
- Evaluation of a Spanish-language Adaptation of Brief Mindfulness-Oriented Recovery Enhancement for Chronic Pain: A Pilot Randomized Controlled Trial International Journal of Behavioral Medicine June 12, 2026
- Single-Session Group Breathwork Intervention for Chronic Pain: A Proof-of-Concept Study of Guided Respiration Mindfulness Therapy. Journal of Integrative and Complementary Medicine May 1, 2026
and 4 more in the library
Cites 18
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Disentangling self from pain: mindfulness meditation–induced pain relief is driven by thalamic–default mode network decoupling Pain July 7, 2022
- Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care JAMA Internal Medicine February 28, 2022
- 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 June 24, 2021
and 13 more in the library