Concurrent changes in psychological distress and pain thresholds following brief mindfulness: an exploratory phenotyping study of chronic pain.
Kento Ueda, Hideaki Hasuo, Junji Nishiyama, Hisaharu Shizuma, Fumie Kato, Kohei Yoshida, Mei Xing, Tetsuya Abe, Kenji Kanbara
Frontiers in Psychology May 1, 2026 DOI: 10.3389/fpsyg.2026.1759576 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Exploratory pre-post intervention study Peer reviewed |
|---|---|
| Sample size | 50 |
| Population | Female outpatients with chronic pain |
| Intervention | Brief mindfulness intervention |
| Duration | 2-week intervention, assessed pre- and post-intervention |
| Measures | Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), pressure pain threshold (PPT) |
| Topics | Meditation |
| Keywords | Chronic pain Central sensitization Pressure pain threshold Top-down modulation Clinical phenotyping Brief mindfulness intervention Precision pain care |
| Key points | The two-week brief mindfulness intervention produced no statistically significant group-level pre-post changes in psychological distress or pressure pain threshold. Exploratory analyses indicated that, within individuals, reductions in catastrophizing, anxiety, and depression co-varied with increases in pressure pain threshold, and identified a highly responsive subgroup the authors call "high psychological improvement" that showed significant concurrent increases in pressure pain threshold, which they suggest may represent a distinct clinical phenotype. |
Abstract
Background: Clinical trials of brief mindfulness interventions (BMIs) for chronic pain frequently report small average effect sizes, which may mask substantial heterogeneity in treatment responses. Rather than testing general efficacy, this exploratory study investigated whether a BMI is associated with concurrently coupled psychological and sensory improvements within individuals, potentially reflecting top-down nociceptive modulation.
Methods: Fifty female outpatients with chronic pain completed a 2-week BMI. Psychological distress [pain catastrophizing scale (PCS) and hospital anxiety and depression scale (HADS)] and objective sensory markers of central sensitization [pressure pain threshold (PPT)] were assessed pre- and post-intervention. To explore treatment response heterogeneity, multivariate analyses-including principal component analysis (PCA) and cluster analysis-were conducted using individual change scores.
Results: At the group level, the BMI did not produce statistically significant pre-post changes. However, exploratory multivariate analyses revealed strong intra-individual coupling of responses. PCA extracted a single dimension, "simultaneous psychological and sensory improvement," suggesting that reductions in catastrophizing, anxiety, and depression co-varied concurrently with increases in PPT. Furthermore, cluster analysis identified a highly responsive subgroup ("high psychological improvement") that exhibited significant concurrent increases in PPT, potentially representing a distinct clinical phenotype.
Conclusion: The true impact of BMIs in chronic pain may lie not in uniform group-level efficacy, but in the concurrent coupling of psychological and sensory improvements within specific individuals. These findings challenge "one-size-fits-all" approaches, highlighting the critical need for mechanism-based patient stratification to advance precision pain care.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |