Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity

Mary Davis, Alex J. Zautra, Laurie D. Wolf, Howard Tennen, Ellen W. Yeung

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Objective: This study compared the impact of cognitive- behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stressrelated changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA). Method: One hundred forty-three RA patients were randomized to 1 of the 3 treatment conditions. CBT-P targeted pain-coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; E provided information regarding RA pain and its management. At pre- and posttreatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects. Results: Multilevel models compared groups in the magnitude of within-person change in daily pain and stress reactivity from pre- to posttreatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E. Conclusions: For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life.

Original languageEnglish (US)
Pages (from-to)24-35
Number of pages12
JournalJournal of consulting and clinical psychology
Volume83
Issue number1
DOIs
StatePublished - Jan 1 2015

    Fingerprint

Keywords

  • Arthritis
  • Cognitive- behavioral
  • Interventions
  • Mindfulness
  • Pain
  • Reactivity

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this