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Psychological flexibility in adults with chronic pain: a study of acceptance, mindfulness, and values-based action in primary care.

Lance M. McCracken, Sophie C Velleman

Pain January 2010 DOI: 10.1016/j.pain.2009.10.034 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Observational survey Peer reviewed
Sample size 239
Population Adults with chronic pain recruited through General Practitioners in UK primary care
Topics Meditation
Key findings Components of psychological flexibility (acceptance of chronic pain, mindfulness, psychological acceptance, values-based action) were significantly correlated with health status and pain-related GP visits. In regressions including pain intensity, psychological flexibility accounted for 3.9% to 40.0% of variance (average 24.1%), versus 9.2% for pain intensity, suggesting psychological flexibility may reduce the impact of chronic pain in primary care, though the authors caution that a low response rate limits generality.

Abstract

There is an increasing number of studies of acceptance, mindfulness, and values-based action in relation to chronic pain. Evidence from these studies suggests that these processes may be important for reducing the suffering and disability arising in these conditions. Taken together these processes entail an overarching process referred to as "psychological flexibility." While these processes have been studied in people with chronic pain contacted in specialty treatment centers, they have not yet been investigated in primary care. Thus, participants in this study were 239 adults with chronic pain surveyed in primary care, through contact with their General Practitioners (GPs), in the UK. They completed measures of acceptance of chronic pain, mindfulness, psychological acceptance, values-based action, health status, and GP visits related to pain. Correlation coefficients demonstrated significant relations between the components of psychological flexibility and the measures of health and GP visits. In regression analyses, including both pain intensity and psychological flexibility as potential predictors, psychological flexibility accounted for significant variance, DeltaR(2)=.039-.40 (3.9-40.0%). In these regression equations pain intensity accounted for an average of 9.2% of variance while psychological flexibility accounted for 24.1%. These data suggest that psychological flexibility may reduce the impact of chronic pain in patients with low to moderately complex problems outside of specialty care. Due to a particularly conservative recruitment strategy the overall response rate in this study was low and the generality of these results remains to be established.

Comparable studies

Other cross-sectional and survey studies on meditation, most cited first.

Study Year Design Participants
Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples Experienced meditators and nonmeditating comparison groups 2008 Cross-sectional study
Neural Correlates of Dispositional Mindfulness During Affect Labeling Adult participants 2007 Observational cross-sectional n = 27
Assessing mindfulness in children and adolescents: Development and validation of the Child and Adolescent Mindfulness Measure (CAMM). School-aged children and adolescents 2011 Cross-sectional validation study n = 1,413
Mindfulness and self-compassion as predictors of psychological wellbeing in long-term meditators and matched nonmeditators Experienced meditators and demographically matched nonmeditators 2012 Cross-sectional study n = 152
Mechanisms of Action in the Inverse Relationship Between Mindfulness and Psychological Distress Undergraduates 2008 Cross-sectional, correlational

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