The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache

Day, Melissa A. and Thorn, Beverly E. (2016) The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache. Complementary Therapies in Medicine, 25 51-54. doi:10.1016/j.ctim.2016.01.002

Author Day, Melissa A.
Thorn, Beverly E.
Title The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache
Journal name Complementary Therapies in Medicine   Check publisher's open access policy
ISSN 0965-2299
Publication date 2016-04-01
Sub-type Article (original research)
DOI 10.1016/j.ctim.2016.01.002
Open Access Status Not Open Access
Volume 25
Start page 51
End page 54
Total pages 4
Place of publication London, United Kingdom
Publisher Churchill Livingstone
Language eng
Subject 3603 Complementary and Manual Therapy
2707 Complementary and alternative medicine
2902 Advanced and Specialised Nursing
Abstract Objectives: This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy). Design: A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N = 24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted. Results: Pain acceptance emerged as a significant mediator of the group-interference relation (p < .05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p < .05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference. Conclusions: Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache.
Keyword Mindfulness-based cognitive therapy
Pain acceptance
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Psychology Publications
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Created: Tue, 26 Jan 2016, 22:51:40 EST by Melissa Day on behalf of School of Psychology