Mindfulness-Oriented Recovery Enhancement Reduces Pain Attentional Bias in Chronic Pain Patients
Abstract
Background Chronic pain involves hypervigilance for pain-related stimuli. Selective attention to pain-related stimuli, known as pain attentional bias (AB), can exacerbate chronic pain, prolong suffering, and undermine quality of life. The aim of this study was to determine if a multimodal mindfulness-oriented intervention could significantly reduce pain AB among chronic pain patients receiving opioid analgesics. Methods A total of 67 chronic pain patients were randomized to an 8-week Mindfulness-Oriented Recovery Enhancement (MORE) intervention or a social support group intervention and began treatment. A dot probe task was used to measure pain AB. Primary outcomes were pain AB scores for cues presented for 2,000 and 200 ms. Results Prior to intervention, participants exhibited a significant bias towards pain-related cues presented for 2,000 ms, but no bias for cues presented for 200 ms. A statistically significant time × intervention condition interaction was observed for 2,000 ms pain AB, such that participants in MORE evidenced significantly reduced posttreatment pain AB relative to pretreatment levels, whereas no significant pre-post treatment changes in pain AB were observed for support group participants. Decreases in pain AB were associated with increased perceived control over pain and attenuated reactivity to distressing thoughts and emotions. Conclusion Study findings provide the first indication that a mindfulness-oriented intervention may reduce pain AB among adul…
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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).”
From Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity (2015) · cites this paper as Garland & Howard, 2013
Increasing the capacity to sustain awareness without judgment when faced with pain or stress may decrease automatic maladaptive responses such as hypervigilance and catastrophizing.
“Increasing the capacity to sustain awareness without judgment when faced with pain or stress may be key to decreasing automatic, maladaptive responses, including hypervigilance to threats and catastrophizing (Garland et al., 2012; Garland & Howard, 2013).”
From Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity (2015) · cites this paper as Garland & Howard, 2013
A mindfulness-oriented intervention may reduce attentional bias for pain-related stimuli in chronic pain patients.
“Furthermore, in a treatment study, Garland and Howard (2013) provided a first tentative indication that a mindfulness-oriented intervention may reduce attentional bias for pain-related stimuli in chronic pain patients.”
From Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies (2019) · cites this paper as Garland and Howard 2013
In individual studies, MBIs produced significant decreases in attentional bias, addictive automaticity, dysphoric affect, and pain severity and related functional interference in patients with chronic pain.
“as well as decreases in attentional bias [52, 66, 67], addictive automaticity [66], dysphoric affect [40, 66], and pain severity and related functional interference in patients with chronic pain [41].”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [67]
Taking part in MORE was linked to less attentional bias toward emotionally threatening cues.
“participation in MORE was associated with reduced attentional bias for emotionally threatening cues,45”
Mindfulness and hypnosis appear to help alleviate pain via corticothalamic modulation of ascending nociceptive input.
“However, mindfulness and hypnosis appear to help alleviate pain via corticothalamic modulation of ascending nociceptive input.[90][91][92][93]”
From Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis (2020) · cites this paper as [91]
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- Authors
- Garland, E. L., & Howard, M. O.
- Affiliations
- University of Utah (US)
- University of North Carolina at Chapel Hill (US)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2013
- Volume
- 82
- Issue
- 5
- Pages
- 311-318
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W1967135006
- Cited by
- 141
- References
- 47
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 7 · 2023: 10 · 2022: 11 · 2021: 10 · 2020: 16 · 2019: 13 · 2018: 9 · 2017: 14 · 2016: 8 · 2015: 6 · 2014: 14 · 2013: 4 · 2012: 1
- FWCI
- 11.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- chronic pain, Mindfulness-Oriented Recovery Enhancement, mindfulness-based interventions, opioid analgesics, dot-probe task, non-pharmacological pain management, prescription opioid misuse
- MeSH terms
- Adaptation, Psychological, Adult, Analgesics, Opioid, Anxiety, Attention, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Quality of Life, Reaction Time, Models, Statistical, Intention to Treat Analysis, Pain Perception, Chronic Pain, Mindfulness
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