Mindfulness-based Cognitive Therapy and Persistent Pain in Women Treated for Primary Breast Cancer: Exploring Possible Statistical Mediators: Results From a Randomized Controlled Trial.
Maja Johannsen, Maja O'Connor, Mia S O'Toole, Anders B Jensen, Robert Zachariae
Clinical Journal of Pain January 2018 DOI: 10.1097/ajp.0000000000000510 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary mediation analysis of a randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 129 |
| Population | Women treated for primary breast cancer with persistent pain |
| Intervention | Mindfulness-based cognitive therapy (MBCT) |
| Duration | Baseline, postintervention, 3-month and 6-month follow-ups |
| Measures | 11-point numeric rating scale, Five Facet Mindfulness Questionnaire, Short-Form Self-Compassion Scale, Pain Catastrophizing Scale |
| Topics | Meditation |
| Key findings | Pain catastrophizing and mindfulness nonreactivity each statistically mediated the effect of MBCT on pain intensity, but in a multiple mediator model only pain catastrophizing remained significant, explaining 78% of the effect. Self-compassion did not show a significant indirect effect. |
Abstract
The aim of this study was to investigate possible statistical mediators in a randomized controlled trial of mindfulness-based cognitive therapy (MBCT) on pain intensity in women treated for primary breast cancer. The sample consisted of 129 women treated for breast cancer, presenting with persistent pain, who were randomly assigned to MBCT or a wait-list control. We previously reported a statistically significant and robust effect of MBCT on pain intensity (11-point numeric rating scale), which was included as the primary outcome. The proposed mediators were mindfulness (the Five Facet Mindfulness Questionnaire), self-compassion (the Short-Form Self-Compassion Scale), and pain catastrophizing (the Pain Catastrophizing Scale). Measurement points included baseline (T1), postintervention (T2), and 3- (T3) and 6-month (T4) follow-ups. All indirect effects of the mediators were tested in separate Multilevel Models, using the product-of-coefficients approach with bias-corrected confidence intervals (95% BSCI). The statistically significant mediators were then included in a multiple mediator model. Statistically significant indirect effects were found for mindfulness nonreactivity (B=-0.17, BSCI [-0.32 to -0.04]) and pain catastrophizing (B=-0.76, BSCI [-1.25 to -0.47]). No statistically significant indirect effect was found for self-compassion (B=-0.09, BSCI [-0.30 to 0.04]). In a multiple mediator model, including mindfulness nonreactivity and pain catastrophizing, only pain catastrophizing remained statistically significant (B=-0.72, BSCI [-1.19 to -0.33]), explaining 78% of the effect. The results of the present study may have clinical implications. An increased focus on the proposed mediators may optimize the clinical use of MBCT for persistent pain in women treated for breast cancer.
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 12
- Mindfulness‐based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta‐analysis of randomized controlled trials Psycho-Oncology September 11, 2019
- Promising Subjective and Objective Benefits of Modified Mindfulness-Based Stress Reduction Training for Chinese Adults with Chronic Pain: A Pilot Randomized Control Study. Pain and therapy December 1, 2023
- The Efficacy of Mindfulness-Based Cognitive Therapy on Disease Perception, Body Image, and Fear of Cancer Recurrence in Women with Breast Cancer Journal of Health Reports and Technology July 15, 2023
- Immediate impact of Mindfulness-Based Cognitive Therapy (MBCT) among women with breast cancer: a systematic review and meta-analysis BMC Women's Health June 22, 2023
- A Systematic Review of the Adherence to Home-Practice Meditation Exercises in Patients with Chronic Pain. International Journal of Environmental Research and Public Health March 2, 2023
and 7 more in the library
Cites 19
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness-Based Stress Reduction for Health Care Professionals: Results From a Randomized Trial. International Journal of Stress Management May 1, 2005
- Mindfulness and self-compassion as predictors of psychological wellbeing in long-term meditators and matched nonmeditators The Journal of Positive Psychology April 11, 2012
- A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology June 18, 2012
- Clinical and psychological moderators of the effect of mindfulness-based cognitive therapy on persistent pain in women treated for primary breast cancer - explorative analyses from a randomized controlled trial. Acta oncologica February 2017
and 14 more in the library