Mindfulness, functioning and catastrophizing after multidisciplinary pain management for chronic low back pain
Abstract
Summary Relationships between self-reports of mindfulness, catastrophizing, disability and depression were explored before and after a multidisciplinary cognitive-behavioural intervention for chronic pain. We examined mindfulness in people with chronic low back pain who were attending a multidisciplinary pain management programme. Participants completed questionnaires at baseline (n = 116) and after a 3-month cognitive-behaviourally informed multidisciplinary intervention (n = 87). Self-reported mindfulness was measured before and after the intervention, and relationships were explored between mindfulness, disability, affect and pain catastrophizing. Mindfulness increased following participation in the intervention, and greater mindfulness was predictive of lower levels of disability, anxiety, depression and catastrophizing, even when pain severity was controlled. Mediator analyses suggested that the relationship between mindfulness and disability was mediated by catastrophizing. It is possible that cognitive-behavioural interventions and processes can affect both catastrophizing and mindfulness.
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Pain catastrophizing mediates the effect of mindfulness on disability and depression, and the effect of pain catastrophizing on depression is mediated by mindfulness.
“In addition, pain catastrophizing has been found to mediate the effect of mindfulness on disability and depression. Moreover, the effect of pain catastrophizing on depression was mediated by mindfulness [14].”
From A 13-weeks mindfulness based pain management program improves psychological distress in patients with chronic pain compared with waiting list controls (2016) · cites this paper as [14]
Few studies have investigated the mechanisms of improved patient functioning in chronic pain.
“Although correlations between mindfulness and acceptance and various measures of distress and well-being have been reported [15, 17], few studies have investigated the mechanisms of improved patient functioning in chronic pain [14].”
From A 13-weeks mindfulness based pain management program improves psychological distress in patients with chronic pain compared with waiting list controls (2016) · cites this paper as [14]
Increased level of mindfulness is positively associated with lower levels of pain related anxiety, depression and disability, and lower levels of pain catastrophizing.
“More specifically, increased level of mindfulness has been positively associated with lower levels of pain related anxiety, depression and disability [5, 14, 15], and lower levels of pain catastrophizing [14].”
From A 13-weeks mindfulness based pain management program improves psychological distress in patients with chronic pain compared with waiting list controls (2016) · cites this paper as [14]
Scores above 24 on the PCS have been categorized as indicating a high risk for reduced functioning.
“Scores above 24 on the PCS have been categorized as indicating a high risk for reduced functioning [37].”
The reduction in catastrophizing and the increase in acceptance support previous studies that show negative correlations between mindfulness and acceptance, and catastrophizing.
“The reduction in catastrophizing and the increase in acceptance support previous studies that show negative correlations between mindfulness and acceptance, and catastrophizing [37,53,54].”
Our findings are aligned with a growing body of evidence showing that in patients with chronic pain, mindfulness and participation in mindfulness-based interventions are related to decreases in pain catastrophizing.
“Furthermore, our findings are aligned with a growing body of evidence showing that in patients with chronic pain, mindfulness and participation in mindfulness-based interventions are related to decreases in pain catastrophizing (e.g., Schutze et al., 2010; Cassidy et al., 2012; Garland et al., 2012; Day et al., 2014) but see (de Boer et al., 2014).”
From Effects of mindfulness-based cognitive therapy on body awareness in patients with chronic pain and comorbid depression (2016) · cites this paper as Cassidy et al., 2012
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- Authors
- Cassidy, E. L., Atherton, R. J., Robertson, N., Walsh, D. A., & Gillett, R.
- Affiliations
- University of Nottingham (GB)
- Sherwood Forest Hospitals NHS Foundation Trust (GB)
- University of Leicester (GB)
- Corresponding author
- Cassidy, Emma Louise
- Venue
- Pain
- Published
- 2012-03
- Volume
- 153
- Issue
- 3
- Pages
- 644-650
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2076286636
- Cited by
- 102
- References
- 45
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 9 · 2020: 10 · 2019: 11 · 2018: 7 · 2017: 6 · 2016: 9 · 2015: 7 · 2014: 11 · 2013: 10 · 2012: 4
- FWCI
- 7.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- mindfulness, pain catastrophizing, chronic low back pain, multidisciplinary pain management, cognitive-behavioural intervention, disability, depression, anxiety, pain intensity, mediation
- MeSH terms
- Adolescent, Adult, Aged, Anxiety, Awareness, Cross-Sectional Studies, Depression, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Middle Aged, Pain Measurement, Surveys and Questionnaires, Regression Analysis, Retrospective Studies, Low Back Pain, Young Adult, Catastrophization, Chronic Pain, Pain Management
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