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Cited by 146Mindfulness and Compassion InterventionsMusculoskeletal pain and rehabilitationPediatric Pain Management Techniques

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

Open access
Davis, Mary C., Zautra, Alex J., Wolf, Laurie D., Tennen, Howard, Yeung, Ellen W.·2015·Journal of Consulting and Clinical Psychology
DOI 10.1037/a0038200PMC PMC4323633
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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. © 2014 American Psychological Association.

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Registry

Crossref · 10.1037/a0038200

Cites

50 of 50 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

2 of 34 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Even well-trained individuals use cognitive reappraisal effectively only in low but not high stress conditions.

    “Moreover, even when individuals are well-trained in the use of cognitive reappraisal strategies to manage fear responses to an aversive stimulus, they use those strategies effectively only in low but not high stress conditions (Raio, Orederu, Palazzolo, Shurick, & Phelps, 2013).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Raio, Orederu, Palazzolo, Shurick, & Phelps, 2013 source

      The Discussion reports that, after cognitive regulation training, only the nonstressed group reduced fear arousal; the stressed group did not. But the Methods describe a single training session followed by a test the next day, not well-trained individuals, and characterize the stress induction as mild to moderate rather than high stress. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Findingown data

    The CBT-P group showed less pronounced pre-to-post decreases in perceived pain control on days of high pain.

    “The CBT-P group showed less pronounced decreases from pre- to post-intervention in perceived pain control on days of high pain (Time × Δ Pain t = 2.89, p < .004).”
    Quote in the paperSubstantial claim
  • Findingown data

    M showed greater improvement in stress-related changes in anxious affect than CBT-P and E.

    “The M group also showed greater improvement in stress-related changes in anxious affect than did CBT-P and E (Group × Time × Δ Pain ts <− 2.07, ps < .04; see Figure 4).”
    Quote in the paperSubstantial claim
  • Findingown data

    For individuals with a history of recurrent depression, M yielded greater improvements than CBT-P and E in pain-related changes in fatigue.

    “Follow-up analyses within each RD group revealed that for individuals with a history of recurrent depression, M yielded greater improvements than did CBT-P and E in pain-related changes in fatigue (Group × Time × Δ Pain ts < − 3.59, ps < .0003).”
    Quote in the paperSubstantial claim
  • Findingown data

    No other group differences in reactivity reached significance.

    “No other group differences in reactivity achieved significance.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 35
  • Classified as probably not a substantial claim. 23

  • May combine two claims.

    Premisecitation

    Individuals choose reappraisal when negative emotional intensity is low, but prefer distraction when intensity is high.

    “In fact, individuals choose to engage in reappraisal to regulate their emotions only when negative emotional intensity is low, but prefer to use distraction when negative emotional intensity is high (Sheppes, Scheibe, Suri, & Gross, 2011).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Sheppes, Scheibe, Suri, & Gross, 2011 source

      The General Discussion reports a relative preference for reappraisal at low negative intensity and distraction at high intensity. The citing sentence’s “only when” overstates this finding: the Results and discussion show that participants also chose reappraisal on some high-intensity trials. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    The M group showed pre-to-post improvement in the relations between pain episodes and changes in disability and fatigue, and between stress episodes and changes in serene and anxious affect.

    “The M group also showed pre-to-post improvement in relations between pain episodes and changes in disability and fatigue (Time ts < −2.69, ps < .008), and between stress episodes and changes in serene affect (Time × Δ Stress t = 2.18, p < .03), and anxious affect (Time × Δ Stress t = −2.17, p < .03).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The M group showed pre-to-post improvement in overall levels of catastrophizing, disability, and serene affect.

    “With regard to changes in overall levels of each outcome, the M group showed pre-to-post improvement in levels of catastrophizing (Time t = −2.54, p < .02), disability (Time t = −10.17, p < .0001), and serene affect (Time t = 5.48, p < .0001).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The sample was predominantly female and Caucasian, with a mean age of about 54 years.

    “The sample was primarily female (68.5%) and Caucasian (85%), with an average age of 54.28 years (SD = 13.80, range 21 to 81).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The E group showed greater pain reactivity from pre to post, with strengthened associations between daily pain episodes and same-day catastrophizing.

    “Moreover, the E group showed greater pain-reactivity from pre to post, reflected in strengthened associations between daily pain episodes and same-day catastrophizing from pre-to-post treatment (Time × Δ Pain t = 2.15, p < .05; see Figure 3, Panel C).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The CBT-P group showed greater pain reactivity from pre- to post-treatment, with strengthened associations between daily pain episodes and same-day fatigue and disability.

    “Moreover, the CBT-P group actually showed greater pain-reactivity from pre- to post-treatment, reflected in strengthened associations between daily pain episodes and same-day fatigue and disability (Time × Δ Pain ts > 1.97, ps < .05; see Figure 3, Panel B).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The CBT-P group showed pre-to-post improvement in overall levels of catastrophizing, pain control, disability, and fatigue.

    “With regard to changes in overall levels of each outcome, the CBT-P group showed improvement from pre- to post-treatment in levels of catastrophizing (Time t = −3.85, p < .0003), as well as pain control (Time t = 3.35, p < .002), disability (Time t = −7.55, p < .0001), and fatigue (Time t = −4.01, p < .0002).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    M improved in overall serene affect more than CBT-P and E, and in overall disability more than CBT-P.

    “Finally, the M group improved in levels of serene affect more than did CBT-P and E (Group × Time ts > 3.58, ps < .0001), and in levels of disability more than the CBT-P group (Group × Time t = − 2.25, p < .03).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The E group showed improvement in overall levels of perceived pain control and disability, but worsening in overall levels of catastrophizing.

    “With regard to changes in overall levels of outcomes, the E group showed improvement in levels of perceived pain control (Time t = 2.47, p < .02) and disability (Time t = −6.73, p < .0001), but worsening in levels of catastrophizing (Time t = 2.49, p < .02).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The observed differences were statistically significant but very small in magnitude.

    “Fourth, the differences we observed were statistically significant but very small in magnitude.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The project manager randomly assigned day clusters to treatment conditions using a random numbers table.

    “The project manager, under the supervision of the study's principal investigator, randomly assigned these day clusters to one of three treatment conditions using a random numbers table.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Decreased pain-related anxiety has been linked to improved outcomes among individuals with chronic pain.

    “decreased pain-related anxiety has been linked to improved outcomes among individuals with chronic pain (McCracken & Gross, 1998).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites McCracken & Gross, 1998 source

  • Classified as probably not a substantial claim.

    Study design and conductown data

    144 participants with rheumatoid arthritis were randomly allocated to cognitive-behavioral therapy for pain (n=52), mindful awareness and acceptance treatment (n=48), or arthritis education (n=44).

    “The 144 participants were randomly allocated to one of three conditions: CBT-P (n=52), M (n=48), or E (n=44).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    143 rheumatoid arthritis patients were randomized to one of three treatment conditions.

    “143 RA patients were randomized to one of the three treatment conditions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Allowing the slopes for pain changes to vary randomly improved the fit of the models.

    “We also allowed the slopes reflecting changes in pain to vary randomly because doing so improved the fit of the models.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Diary data have the potential to shed light on intervention-related changes in the dynamics of behavior in real-world contexts.

    “The primary advantage, though, is that diary data have the potential to shed light on intervention-related changes in the dynamics of behavior in real-world contexts (Shiffman et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shiffman et al., 2008 source

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Allowing intercepts to vary randomly in the models supports generalizing findings to the population of persons and daily observations.

    “For all analyses, we allowed intercepts to vary randomly, thus enabling us to generalize the findings to the population of persons from which the sample was drawn and the populations of observations from which their daily reports were sampled.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Among pain patients, mindfulness training versus control showed decreases in attentional bias to and increases in disengagement from pain-related cues.

    “Among pain patients, those exposed to mindfulness training versus a control condition showed decreases in attentional bias to and increases in disengagement from pain-related cues, assessed through use of the dot probe technique (Garland & Howard, 2013; Vago & Nakamura, 2011).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Garland & Howard, 2013 source
    • cites Vago & Nakamura, 2011 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Diary compliance was high: 95% of pre diaries and 92.5% of post diaries were completed, and 97.3% of completed diaries had a verified postmark.

    “Aggregating across participants, 95% of the pre diaries and 92.5% of the post diaries were completed, and of those completed diaries, 97.3% were received with a verified postmark.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Of diaries with a verified postmark, 80% were postmarked within 2 days of diary completion.

    “Of the diaries with a verified postmark, 80% were postmarked within 2 days of diary completion (allowing for weekend and holiday constraints on mail service).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The lower order, empirically derived subscales of the PANAS-X reflect specific dimensions of positive and negative affect and show good psychometric properties.

    “The lower order, empirically-derived subscales of the PANAS-X reflect specific dimensions of positive and negative affect, consistent with existing models of emotion, and show good psychometric properties (Watson & Clark, 1994).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Watson & Clark, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    The estimated intraclass correlation in the current sample was .58 for pain and .54 for fatigue.

    “The intraclass correlation estimates were .58 for pain and .54 for fatigue.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Morning stiffness assessment is a widely used marker of functional disability in rheumatoid arthritis and reflects disease activity more than traditional markers of inflammation like joint counts.

    “This assessment of morning stiffness is a widely used marker of functional disability in RA and reflects disease activity more than do traditional markers of inflammation like joint counts (Westhoff, Buttgereit, Gromnica-Ihle, & Zink, 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Westhoff, Buttgereit, Gromnica-Ihle, & Zink, 2008 source

  • May combine two claims.

    Premisecitation

    Gil and colleagues found that on days of high pain, children with sickle cell disease who reported higher use of coping practice were significantly less likely to have contact with health care providers and to decrease school participation.

    “On days of high pain, if children also reported higher use of coping practice, they were significantly less likely to have contact with health care providers and to decrease school participation.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gil et al., 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    A first-order autoregressive term was included in all models to address autocorrelated residuals.

    “Autocorrelated residuals are a common consequence of equally spaced observations and can bias standard errors and significance levels; thus, a first order autoregressive term [i.e., AR(1)] was included in all models.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    At pre-treatment, the groups were comparable in overall levels of catastrophizing, disability, fatigue, and serene and anxious affects.

    “With regard to overall levels of outcomes aggregated across the 30 days of pre-treatment diaries, groups were comparable in their levels of catastrophizing, disability, fatigue, and serene and anxious affects (Group main effect ps > .05).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Mindfulness helps shift attention away from affect-laden appraisals toward sensory aspects, reducing reactivity in individuals with somatic symptoms.

    “In particular, mindfulness helps to shift attention away from affect-laden appraisals (e.g., catastrophizing) toward the sensory aspects of experience, reducing reactivity to aversive events in individuals with somatic symptoms (Garland et al., 2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Garland et al., 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisecitation

    A recent meta-analysis of randomized clinical trials of acceptance-based treatments for chronic pain indicated small improvements in pain and depression and small to moderate improvements in physical well-being relative to education controls or treatment-as-usual.

    “A recent meta-analysis of randomized clinical trials of acceptance-based treatments for chronic pain indicated that they yield small improvements in pain and depression, and small to moderate improvements in physical well-being relative to education controls or treatment-as-usual (Veehof, Oskam, Schreurs, & Bohlmeijer, 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Veehof, Oskam, Schreurs, & Bohlmeijer, 2011 source

  • May combine two claims.

    Study design and conductown data

    The three intervention groups did not differ at baseline in age, income, education, or proportions of females and Caucasians.

    “The three intervention groups were comparable in age, income, and education (Fs < 1.58, ps > .21), and in proportions of females and Caucasians (χ2 (2) < 3.32, ps > .19).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    One participant in the mindful awareness and acceptance condition was dropped from the pre-post diary analyses because she did not complete any diary reports, leaving 143 participants for analysis.

    “Of the 144 individuals who were randomized, 1 participant in the M condition was dropped from the pre-post diary analyses because she did not complete any diary reports.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Clinicians reviewed treatment manuals with the treatment team before delivering interventions to maximize treatment fidelity, and a supervisor conducted weekly review sessions to foster adherence.

    “Prior to delivering the interventions, clinicians reviewed the treatment manuals with the treatment team to maximize treatment fidelity across the eight waves of groups. During treatment waves, the treatment supervisor conducted weekly review sessions to foster adherence and address clinical issues arising in treatment groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    A three-level analytic approach retained the same pattern of results for pain and stress reactivity as the main analyses.

    “Repeating the analyses using a three-level approach (i.e., diary days, pre-post assessment, and individuals as levels) retained the pattern of findings for pain- and stress-reactivity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Acceptance-oriented treatments typically include exercises to illustrate mindfulness principles, often incorporating regular mindfulness meditation to build awareness and acceptance.

    “Acceptance-oriented treatments typically include exercises designed to illustrate the principles of mindfulness; with notable exceptions (e.g., Hayes & Duckworth, 2006), these exercises incorporate the regular practice of mindfulness meditation to build the capacity for increased awareness and acceptance.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hayes & Duckworth, 2006 source

  • May combine two claims.

    Interpretationown data

    Mindfulness was the most effective approach for dampening pain-contingent increases in catastrophizing, fatigue, and disability, and stress-contingent increases in anxious affect.

    “Specifically, mindful awareness and acceptance was the most effective approach in dampening pain-contingent increases in catastrophizing, fatigue, and disability, and stress-contingent increases in anxious affect.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    CBT involves reinterpreting the meaning of an experience to change emotional response.

    “CBT, on the other hand, involves reinterpreting the meaning of an experience to change one's emotional response to it.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study demonstrated that CBT and mindfulness impacted daily reactivity but did not address how these reductions were accomplished.

    “Sixth, the study demonstrated that CBT and mindfulness-based treatment impacted daily reactivity, but it did not address how these reductions were accomplished.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Both mindfulness and CBT improved overall catastrophizing, but only mindfulness improved the ability to limit catastrophizing during high daily pain.

    “With regard to catastrophizing, although both the mindfulness and CBT conditions improved overall levels, only mindfulness also improved individuals’ ability to limit catastrophizing when confronting periods of high daily pain.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Cognitive reappraisal is often deployed after emotions have intensified, and its success hinges on sufficient cognitive resources.

    “Although cognitive reappraisal is effective, it is often deployed after emotions have intensified, and thus its success hinges on the availability of sufficient cognitive resources to implement it.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductreasoning

    The design compared two distinct treatments with an active control, allowing tests of differential effects beyond nonspecific factors.

    “The design compared two distinct treatments (i.e., mindfulness and CBT) with an active control condition (i.e., arthritis education), providing the opportunity to test for differential intervention effects on daily pain and stress reactivity beyond the effects of group support, therapist contact, the passage of time, and other nonspecific factors.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    The effects reflect changes in day-to-day processes, and benefits to overall functioning may increase as small daily changes compound over time.

    “Although small in magnitude, the effects demonstrated here reflect changes in day-to-day processes, and the benefits to overall functioning may increase as small daily changes are compounded over time.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The sample was primarily Caucasian women with RA, which constrains generalizability to similar individuals and pain conditions.

    “First, the sample was comprised primarily of Caucasian women with RA, constraining generalizability of the findings to individuals with a similar background and pain condition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    CBT improved overall perceived control and the capacity to sustain control during pain episodes more than mindfulness.

    “For pain control, CBT improved not only overall levels of perceived control, but also individuals’ capacity to sustain a sense of control during pain episodes to a greater extent than did mindfulness.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Acceptance was more effective in increasing pain tolerance across samples, and in limiting acute distress in clinical but not healthy samples.

    “Acceptance was more effective in increasing pain tolerance across samples, and in limiting acute distress in clinical but not healthy samples.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kohl et al. (2012) source

  • May combine two claims.

    Interpretationown data

    Mindfulness limited the effects of pain flares on catastrophizing, fatigue, and disability, and of stress on anxious affect.

    “Mindfulness limited the effects of pain flares on catastrophizing, fatigue, and disability, and of stress on anxious affect.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Therapeutic change can be effected in subtler ways than can be assessed by static measurement of primary outcomes.

    “These findings serve as a reminder that therapeutic change can be effected in subtler ways than can be assessed by static measurement of primary outcomes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The models tested same-day relations between pain and stress and outcomes but did not test carryover effects from one day to the next.

    “Fifth, the models we evaluated tested same-day relations between pain and stress and study outcomes, but did not test for carryover effects from one day to the next.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Clinicians' training did not include extensive role-playing, rehearsal, or booster sessions.

    “Second, although our treatments were manualized and clinicians supervised throughout treatment delivery, the clinicians’ training regarding treatment delivery did not include extensive opportunities for role-playing, rehearsal, or booster sessions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    The daily assessment used paper-and-pencil diaries, and the study cannot assure that they were completed in the evening.

    “Third, the daily assessment involved paper-and-pencil diaries. Although diaries were mailed back to the research team on a daily basis, and evaluation of postmarks assured compliance with mailing instructions, we cannot assure that the diaries were completed in the evening.”
    Quote in the paperNot a substantial claim
48 of 48

  • The paper relies on this without support.

    From a cognitive-behavioral perspective, an individual's beliefs about physical symptoms and the coping responses stemming from those beliefs are central to adaptation to chronic pain.

    “From a cognitive-behavioral perspective, an individual's beliefs regarding physical symptoms and the coping responses that stem from those beliefs are central to adaptation to chronic pain.”

  • The paper relies on this without support.

    A key facet of cognitive-behavioral therapy is training individuals to apply cognitive reappraisal strategies to address faulty cognitions that contribute to poor adjustment.

    “A key facet of CBT is training individuals to apply cognitive reappraisal strategies to address the faulty cognitions that contribute to their poor adjustment.”

  • The paper relies on this without support.

    Over the long term, cognitive-behavioral therapy aims to improve coping self-efficacy, psychological and physical symptoms, and functional health.

    “Over the long term, CBT aims to improve coping self-efficacy, psychological and physical symptoms, and functional health.”

  • The paper relies on this without support.

    Acceptance-based approaches foster a decentered view that thoughts, emotions, and physical sensations are temporary experiences.

    “Much like CBT, acceptance-based approaches foster the development of a decentered view that thoughts, emotions, and physical sensations are simply temporary experiences.”

  • The paper relies on this without support.

    In contrast to cognitive-behavioral therapy, acceptance-oriented treatments focus on increasing capacity to be aware and nonjudgmental of present moment experiences, including pain and reactions to pain.

    “However, in contrast to the focus in CBT on promoting efforts to challenge and change faulty cognitions to control pain, the focus in acceptance-oriented treatments is on increasing individuals' capacity to be both aware and nonjudgmental of present moment experiences, including pain and their reactions to pain.”

  • The paper relies on this without support.

    Mindfulness training helps individuals attend to current experiences without suppressing or elaborating those experiences.

    “Mindfulness training helps individuals attend to current experiences without suppressing or elaborating those experiences.”

  • The paper relies on this without support.

    An important aim of an acceptance-oriented approach is to decrease automatic cognitive and emotional reactivity to aversive experiences, thereby increasing the ability to act more intentionally in response to pain and other stressors.

    “One important aim of an acceptance-oriented approach is to decrease automatic cognitive and emotional reactivity to aversive experiences, thereby increasing the ability to act more intentionally to response to pain and other stressors.”

  • The paper relies on this without support.

    CBT-P targets the development of pain coping skills.

    “Because CBT-P targeted the development of pain coping skills, we expected it to dampen reactivity to daily pain episodes.”

  • The paper relies on this without support.

    M targets skills to cope with a range of aversive experiences.

    “In contrast, because M targeted skills to cope with a range of aversive experiences, we expected it to dampen not only pain but also stress reactivity day-to-day.”
9 of 9

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Several psychological and pharmacological treatments have notable effects on traits that overlap with the psychological response present in SSD, including health anxiety, anxiety sensitivity, and pain catastrophizing.

    “Moreover, several psychological and pharmacological treatments have notable effects on traits that overlap with the psychological response that is present in SSD, for example, in terms of health anxiety, 34,35 anxiety sensitivity, 36,37 and pain catastrophizing.38,39”

    From Symptom Preoccupation in Fibromyalgia: Prevalence and Correlates of Somatic Symptom Disorder in a Self-Recruited Sample (2020) · cites this paper as [38]

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentt(97) = 3.01reported p < .01 · recomputed p = .003

    “t (97) = 3.01, p < .01”

  • Consistentt(89) = 2.4reported p < .02 · recomputed p = .018

    “t (89) = 2.40, p < .02”

2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Discussion denies a reported change in stress-related serenity

    Major

    The Results section reports a significant pre-to-post improvement in the mindfulness group's relation between stress and serene affect. The Discussion instead says no treatment altered stress-contingent changes in serene affect, including mindfulness.

  • Sample size is reported as 143 and 144

    Minor

    The abstract says 143 rheumatoid arthritis patients were randomized, but the study overview and participants section say 144 individuals were randomized. These statements cannot both be true for the same trial sample size.

  • Education group is described as both unchanged and more reactive

    Minor

    The Results section first says the education group had no pre-to-post change in its pain or stress relations with any outcome, then reports a strengthened relation between pain and catastrophizing.

  • Stress-reactivity comparison is labeled as a pain interaction

    Minor

    The reported comparison concerns stress-related anxious affect but names a Group × Time × Δ Pain interaction. The specified model uses Group × Time × ΔStress for the corresponding stress-reactivity test.

  • Randomized participant count differs

    Minor

    The abstract says 143 patients were randomized, whereas the Methods section says 144 were randomized and one was later excluded from the diary analyses.

5 of 5

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Related

Authors
Davis, M. C., Zautra, A. J., Wolf, L. D., Tennen, H., & Yeung, E. W.
Affiliations
  • Arizona State University (US)
  • UConn Health (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2015-02
Volume
83
Issue
1
Pages
24-35
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/a0038200
PMC
PMC4323633
OpenAlex
W2003876396
Cited by
146
References
50
Citations by year
2026: 6 · 2025: 7 · 2024: 12 · 2023: 11 · 2022: 8 · 2021: 16 · 2020: 12 · 2019: 16 · 2018: 21 · 2017: 15 · 2016: 14 · 2015: 8
FWCI
14.56
Type
journal article
Language
en
Open access
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Musculoskeletal, Immune, and Skin Disease (R01 AR41687)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
mindfulness, rheumatoid arthritis, chronic pain, pain reactivity, stress reactivity, pain catastrophizing, perceived control, fatigue, anxiety, within-person change
MeSH terms
Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid, Female, Humans, Male, Middle Aged, Patient Education as Topic, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult, Catastrophization, Chronic Pain, Mindfulness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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