Mindfulness-Oriented Recovery Enhancement Reduces Pain Attentional Bias in Chronic Pain Patients

A mindfulness-oriented intervention called Mindfulness-Oriented Recovery Enhancement (MORE) reduced pain attentional bias (AB) among chronic pain patients receiving opioid analgesics. Prior to treatment, participants showed a significant bias toward pain-related cues presented for 2,000 milliseconds but not for 200 milliseconds. After an 8-week program, those in MORE showed significantly reduced pain AB compared to their pretreatment levels, while a social support group showed no change. Decreases in pain AB were linked to increased perceived control over pain and less reactivity to distressing thoughts and emotions. The authors propose MORE as a nonpharmacological approach for addressing factors linked to chronic pain.

Study at a glance

Abstract

Background: Chronic pain involves hypervigilance for pain-related stimuli. Selective attention to pain-related stimuli, known as pain attentional bias (AB), can exacerbate chronic pain, prolong suffering, and undermine quality of life. The aim of this study was to determine if a multimodal mindfulness-oriented intervention could significantly reduce pain AB among chronic pain patients receiving opioid analgesics. Methods: A total of 67 chronic pain patients were randomized to an 8-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention or a social support group intervention and began treatment. A dot probe task was used to measure pain AB. Primary outcomes were pain AB scores for cues presented for 2,000 and 200 ms. Results: Prior to intervention, participants exhibited a significant bias towards pain-related cues presented for 2,000 ms, but no bias for cues presented for 200 ms. A statistically significant time × intervention condition interaction was observed for 2,000 ms pain AB, such that participants in MORE evidenced significantly reduced posttreatment pain AB relative to pretreatment levels, whereas no significant pre-post treatment changes in pain AB were observed for support group participants. Decreases in pain AB were associated with increased perceived control over pain and attenuated reactivity to distressing thoughts and emotions. Conclusion: Study findings provide the first indication that a mindfulness-oriented intervention may reduce pain AB among adults suffering from chronic pain. Given the magnitude of chronic pain in postindustrial societies, coupled with the dramatic escalation in prescription opioid misuse, future studies should evaluate MORE as a nonpharmacological means of addressing factors linked with chronic pain.