A Model of the Protective Value of Mindfulness in the Experience of Chronic Pain: Mediating Role of Pain Catastrophizing

Abstract Objectives Dispositional mindfulness appears to exert beneficial effects in the experience of chronic pain and related symptoms. However, there is currently no widely accepted theoretical model that explains the mechanisms underlying this relationship. Furthermore, existing studies often lack sufficient theoretical justification, adequate sample sizes to ensure statistical power, and precise analytical methods to identify the specific mechanisms involved.

Method: The present study analyzed the adequacy of the recent model proposed by Wilson et al. (2023), according to which dispositional mindfulness (assessed via Five Facet Mindfulness Questionnaire) predicts reduced pain perception (assessed via Abbreviated McGill Pain Questionnaire) through decreased pain catastrophizing (Pain Catastrophizing Scale). The study aimed to replicate the original findings in a large sample of the general population (n = 1075) and examine the model in a chronic pain population (n = 467), in which it has not been previously analyzed. Our methodological approach employs structural equation modeling, allowing us to clarify the specific facets of mindfulness that most significantly contribute to this relationship.

Results: Dispositional mindfulness, particularly its facet of non-judgment of inner experience, significantly predicted lower pain scores through decreased pain catastrophizing, specifically in its helplessness dimension, both in the healthy subgroup and in those with chronic pain. These findings replicate those of Wilson et al. (2023) in the general sample and, notably, extend to the chronic pain sample as well.

Conclusions: Our results provide robust evidence supporting the model proposed by Wilson et al. (2023) and extend it by showing that within mindfulness a non-judgment attitude plays a crucial role in reducing helplessness when facing pain. These findings offer valuable insights for developing evidence-based interventions aimed at promoting health and managing chronic pain for which there is still no effective treatments options.