Patients with Chronic Pain: Are Mindfulness Traits Protective Against Distress, Anxiety and Depression?

Chronic pain patients with higher levels of mindfulness attitudes report less distress, anxiety, and depressive symptoms, and greater physical and general well-being, regardless of whether their pain is oncologic or non-oncologic. In a study of 50 patients, those scoring above a mindfulness threshold (26 of 50) had significantly lower scores on measures of pain-related disability, perceived stress, anxiety, and depression, and higher scores on psychological well-being. Mindfulness level was the strongest positive predictor of well-being, while anxiety and pain intensity were negative predictors.

Study at a glance

Abstract

To investigate mindfulness traits/attitudes as protective factors against chronic pain related distress, depression and anxiety. Fifty patients (25 with chronic non-oncologic pain-NOP; 25 with chronic oncologic pain-COP) were administered with the following scales: Visual Analogue Scale (VAS), Pain Disability Index (PDI), Italian Questionnaire for Pain (QUID), Perceived Stress Scale (PSS), State and Trait Anxiety Scale (STAY-y1 module), Beck Depression Inventory II (BDI-II), Pittsburgh Sleep Quality Index (PSQI), Psychological General Well Being Index (PGWBI), Mindful Attention Awareness Scale (MAAS). MAAS value ≥ 4.38 was adopted as cut-off to compare 'high level of mindfulness' (HM) vs. 'normal level of mindfulness' (NM) attitudes. Twenty-six patients (52%) scored ≥4.38, with no different distribution between NOP and COP. HM patients scored significantly lower than NM patients on PDI 'family/home responsibilities' domain (4.5±3.2 vs. 6.4±2.8; p<.037), and on PSS (17.8±2.6 vs. 20.9±2.5; p<.0001), STAY-y1 (9.4±1.8 vs. 10.3±2.1; p<.0001), BDI-II (7.8±5.0 vs. 17.6±8.6; p<.0001) total scores. HM scored significantly higher than NM patients in all PGWBI domains. A multiple regression analysis was carried out to analyze the predictor variables of PGWB. The most complete model considered the variables MAAS, STAIy and VAS (F=42.21; p<.0001), that accounted for the 71.6% of PGWB variance. MAAS score was the only variable positively predicting for PGWB; STAIy and VAS scores predicted negatively. Chronic pain patients with high levels of mindfulness attitudes experienced less distress, anxiety, depressive symptoms, and more physical and general wellbeing than patients with low levels of mindfulness attitudes.