Cognitive fusion and pain experience in young people
Abstract
OBJECTIVES: Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for chronic pain in young people. Cognitive fusion is a key concept of ACT that is hypothesized to contribute to distress and suffering. In this study, we sought to: (1) test hypothesized associations between cognitive fusion and pain intensity, disability, and catastrophizing; and (2) examine the function of cognitive fusion as a possible mediator between catastrophizing and disability. METHODS: A community sample of 281 young people (11 to 20 y) completed measures assessing cognitive fusion, pain intensity, disability, and pain catastrophizing. RESULTS: Cognitive fusion was positively related to pain intensity (r=0.24, P<0.01), disability (r=0.32, P<0.001), and pain catastrophizing (r=0.47, P<0.001). Moreover, cognitive fusion was found to mediate the association between pain catastrophizing and disability (β=0.01, 95% confidence interval=0.002-0.024, 5000 bootstrap resamples). DISCUSSION: The findings indicate that cognitive fusion is moderately to strongly associated with pain-related outcomes, which support the need for further research to (1) better understand the relationship between cognitive fusion and adjustment to chronic pain, and (2) determine whether the benefits of treatments such as ACT are mediated, at least in part, by reductions in cognitive fusion.
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Experiential avoidance can have a moderator effect on pain perception.
“Besides, experiential avoidance can have a moderator effect on pain perception [83].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [83]
There is a previously found relationship between psychological inflexibility and pain and disability in youths.
“This is promising given the previously found relationship to pain and disability in youths, and should be further evaluated in future clinical trials [90].”
From Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: A pilot study (2020) · cites this paper as [90]
Cognitive fusion had a mediating association with catastrophizing coping strategy in a chronic-pain community sample of young people.
“Cognitive fusion had a mediating association with catastrophizing coping strategy in a chronic-pain community sample of young people [30].”
Pain catastrophizing and cognitive fusion are distinct processes that could potentially interact and influence each other.
“Research supports the idea that both processes are distinct and that they could potentially interact and influence each other [18].”
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- Authors
- Solé, E., Tomé-Pires, C., de la Vega, R., Racine, M., Castarlenas, E., Jensen, M. P., & Miró, J.
- Affiliations
- Institut de Recerca Biomèdica Catalunya Sud (ES)
- Unit for the Study and Treatment of Pain—ALGOS
- Western University (CA)
- University of Washington (US)
- Corresponding author
- Solé, Ester
- Castarlenas, Elena
- Miró, Jordi
- Venue
- The Clinical Journal of Pain
- Published
- 2016-07
- Volume
- 32
- Issue
- 7
- Pages
- 602-608
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2333485773
- Cited by
- 47
- References
- 52
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 6 · 2020: 9 · 2019: 5 · 2018: 5 · 2017: 2 · 2016: 3
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- cognitive fusion, pain catastrophizing, chronic pain, youth, pain intensity, disability, acceptance and commitment therapy, mediation
- MeSH terms
- Adolescent, Age Factors, Child, Cognition, Disability Evaluation, Female, Humans, Male, Models, Psychological, Pain Measurement, Psychological Tests, Young Adult, Catastrophization, Pain Perception, Chronic Pain, Acceptance and Commitment Therapy
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