Acceptance, mindfulness, and values-based action may counteract fear and avoidance of emotions in chronic pain: an analysis of anxiety sensitivity.
Lance M. McCracken, Edmund Keogh
Journal of Pain April 2009 DOI: 10.1016/j.jpain.2008.09.015 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cross-sectional study Peer reviewed |
|---|---|
| Sample size | 125 |
| Population | Consecutive adult patients (64.8% women) seeking services from a specialty pain service in the United Kingdom |
| Topics | Anxiety Meditation |
| Key findings | Anxiety sensitivity was associated with greater pain, disability, and distress in chronic pain patients. When acceptance of pain, mindfulness, and values-based action were included in regression models, the variance accounted for by anxiety sensitivity fell from about 21% to 4.8%, suggesting these therapeutic processes may reduce the role of fear of anxiety in patient functioning. |
Abstract
People often respond with distress and avoidance to their own negative experiences, such as the physical, cognitive, and emotional aspects of depression or anxiety. When people with chronic pain respond this way, their overall level of distress may increase, they may struggle to avoid their emotional experiences, and their daily functioning may decrease. The purpose of this study was to examine the role of anxiety sensitivity (AS), or "fear of anxiety," in relation to these processes. It was predicted that those persons with chronic pain who report higher AS will also report higher emotional distress and greater disability caused by chronic pain. A second purpose was to examine whether therapeutic processes designed to reduce emotional avoidance, namely, acceptance, mindfulness, and values, could be demonstrated to reduce the role of AS in relation to this distress and disability based on a statistical model including these variables. Subjects were 125 consecutive adult patients (64.8% women) seeking services from a specialty pain service in the United Kingdom. All patients completed a standard set of measures of AS, acceptance of pain, mindfulness, and values-based action, as well as measures of pain, disability, and emotional functioning, at their initial consultation, and these data formed the basis for the current study. In correlation and regression analyses, AS was associated with greater pain, disability, and distress. In regression analyses, the 3 proposed therapeutic processes reduced the average variance accounted for by AS in patient functioning from DeltaR(2) = .21 to DeltaR(2) = .048. This means that when the 3 therapeutic variables are taken into account statistically, AS alone retained relatively little association with patient functioning. These results suggest that AS may amplify the impact of emotional distress on patient functioning in chronic pain and that processes of acceptance, mindfulness, and values-based action may reduce this effect. Humans can fear and struggle to avoid their own emotional experiences, even when these cannot harm them. Data presented here show individuals with chronic pain have more distress and disability when they manifest more fear of anxiety symptoms, and behavior patterns of "acceptance" and "mindfulness" may reduce this effect.
Comparable studies
Other cross-sectional and survey studies on anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. International sample of people who reported having used a psychedelic | 2020 | Cross-sectional survey | n = 985 |
| The Challenging Experience Questionnaire: Characterization of challenging experiences with psilocybin mushrooms Internet survey respondents reporting challenging experiences with psilocybin | 2016 | Questionnaire development and validation | |
| Psychedelics and Mental Health: A Population Study Adult population in the United States | 2013 | Cross-sectional survey | n = 130,152 |
| Ecstasy/MDMA attributed problems reported by novice, moderate and heavy recreational users Ecstasy users who participated in a WWW study of recreational drug use | 2002 | Cross-sectional survey | n = 282 |
| 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) used in a naturalistic group setting is associated with unintended improvements in depression and anxiety. Adults who used 5-MeO-DMT in a group setting with structured procedures | 2019 | Cross-sectional survey | n = 362 |
Citations in the library
Cited by 14
- Mindfulness meditation–based pain relief: a mechanistic account Annals of the New York Academy of Sciences June 1, 2016
- Mindfulness-Based Interventions for Physical Conditions: A Narrative Review Evaluating Levels of Evidence ISRN Psychiatry November 14, 2012
- The effect of mindfulness meditation on the perceived duration of pain Journal of Cognitive Psychology December 7, 2022
- The Role of Mindfulness in Reducing Depression During COVID-19 At-home Treatment. Disaster medicine and public health preparedness April 16, 2025
- Strategies for resolving challenging psychedelic experiences: insights from a mixed-methods study. Scientific Reports November 21, 2024
and 9 more in the library