Psychological factors as mediators of the effectiveness of telehealth mindfulness-based interventions for pain and pain-related conditions.
Stephanie L Taylor, Collin M Calvert, Alexander C. Haley, Roni Evans, Jenna L Adamowicz, Kelli D Allen, Gert Brønfort, Lee J. S. Cross, Elizabeth S Goldsmith, Alexis Grant, Brent D. Leininger, Marianne S Matthias, J Greg Serpa, Brent C Taylor, Diana J. Burgess
Annals of Behavioral Medicine January 7, 2026 DOI: 10.1093/abm/kaag061 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary mediation analysis of a pragmatic randomized controlled trial Peer reviewed |
|---|---|
| Duration | Assessments at 10 weeks and 6 months |
| Topics | Meditation |
| Keywords | Pain Veteran’s health |
| Registration | NCT04526158 |
| Key findings | Reduced pain catastrophizing and increased pain self-efficacy were apparent mechanisms by which the mindfulness-based interventions improved pain interference, pain intensity, and other biopsychosocial outcomes, whereas increased mindfulness was the apparent mechanism for psychological and sleep-related outcomes. The interventions did not affect perceived stress. |
Abstract
Mindfulness meditation is an evidence-based therapy for chronic pain for which some have explored possible mechanisms of action. However, these mechanisms can vary widely depending on the mindfulness-based intervention (MBI). To study possible mechanisms of action of 2 similar MBIs for pain. We used data from our learning to apply mindfulness to pain (LAMP) pragmatic randomized controlled trial comparing usual care with virtual group or self-paced MBIs. The LAMP MBIs included education on adaptive pain behaviors and mindfulness and used shorter, less formal mindfulness practice than standard MBIs. We examined whether mindfulness, pain self-efficacy, pain catastrophizing, and stress mediated the treatment effects on 2 pain and 7 pain-related biopsychosocial outcomes at 10 weeks and 6 months using mediation models. The MBIs improved pain catastrophizing, pain self-efficacy, and mindfulness but did not affect perceived stress. Pain catastrophizing and pain self-efficacy had large mediating effects between the MBIs and pain interference, pain intensity, physical functioning, social functioning, anxiety, fatigue, sleep disturbance, depression, and post-traumatic stress disorder. mindfulness also mediated the above relationships with smaller effects between MBIs and all outcomes except for pain interference, pain intensity, physical functioning, and social functioning. Reduced pain catastrophizing and increased pain self-efficacy were apparent mechanisms of action improving pain interference, pain intensity, and other biopsychosocial outcomes in our MBIs, whereas increased mindfulness was the apparent mechanism of action improving psychological and sleep-related outcomes. This study improves our understanding of mechanisms by which MBIs can affect pain and important pain-related outcomes. clinicaltrials.gov. Identifier: NCT04526158.
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
Cites 15
- The effect of mindfulness meditation on sleep quality: a systematic review and meta‐analysis of randomized controlled trials Annals of the New York Academy of Sciences December 21, 2018
- The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials Perspectives on Psychological Science February 16, 2021
- Mechanism of Action of Mindfulness-Based Interventions for Pain Relief-A Systematic Review. Journal of Integrative and Complementary Medicine December 1, 2024
- Not all mindfulness is equal: certain facets of mindfulness have important implications for well-being and mental health across the lifespan. Frontiers in Psychology 2024
- Relationships Between Applied Mindfulness Practice, Chronic Pain, and Pain-Related Functioning in Veterans. Journal of Pain November 1, 2024
and 10 more in the library