Login to MyKarger

New to MyKarger? Click here to sign up.



Login with Facebook

Forgot your password?

Authors, Editors, Reviewers

For Manuscript Submission, Check or Review Login please go to Submission Websites List.

Submission Websites List

Institutional Login
(Shibboleth or Open Athens)

For the academic login, please select your country in the dropdown list. You will be redirected to verify your credentials.

Regular Article

Mindfulness-Oriented Recovery Enhancement Reduces Pain Attentional Bias in Chronic Pain Patients

Garland E.L.a · Howard M.O.b

Author affiliations

aUniversity of Utah, Salt Lake City, Utah, and bUniversity of North Carolina at Chapel Hill, Chapel Hill, N.C., USA

Related Articles for ""

Psychother Psychosom 2013;82:311-318

Do you have an account?

Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



Login Information





Contact Information










I have read the Karger Terms and Conditions and agree.



To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!

If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.
Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00


Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select

* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Regular Article

Received: September 03, 2012
Accepted: February 10, 2013
Published online: August 09, 2013
Issue release date: August 2013

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 1

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

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 adults suffering from chronic pain. Given the magnitude of chronic pain in postindustrial societies, coupled with the dramatic escalation in prescription opioid misuse, future studies should evaluate MORE as a nonpharmacological means of addressing factors linked with chronic pain.

© 2013 S. Karger AG, Basel


References

  1. Eccleston C, Crombez G: Pain demands attention: a cognitive-affective model of the interruptive function of pain. Psychol Bull 1999;125:356-366.
  2. Pincus T, Morley S: Cognitive-processing bias in chronic pain: a review and integration. Psychol Bull 2001;127:599-617.
  3. Legrain V, Van Damme S, Eccleston C, Davis KD, Seminowicz DA, Crombez G: A neurocognitive model of attention to pain: behavioral and neuroimaging evidence. Pain 2009;144:230-232.
  4. Quevedo AS, Coghill RC: Attentional modulation of spatial integration of pain: evidence for dynamic spatial tuning. J Neurosci 2007;27:11635-11640.
  5. Bantick SJ, Wise RG, Ploghaus A, Clare S, Smith SM, Tracey I: Imaging how attention modulates pain in humans using functional MRI. Brain 2002;125:310-319.
  6. Miron D, Duncan GH, Bushnell MC: Effects of attention on the intensity and unpleasantness of thermal pain. Pain 1989;39:345-352.
  7. Wiech K, Tracey I: The influence of negative emotions on pain: behavioral effects and neural mechanisms. Neuroimage 2009;47:987-994.
  8. Rollman GB: Perspectives on hypervigilance. Pain 2009;141:183-184.
  9. Vlaeyen JWS, Linton SJ: Fear avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317-332.
  10. Afzal M, Potokar JP, Probert CSJ, Munafò MR: Selective processing of gastrointestinal symptom-related stimuli in irritable bowel syndrome. Psychosom Med 2006;68:758-761.
  11. Boyer MC, Compas BE, Stanger C, Colletti RB, Konik BS, Morrow SB, Thomsen AH: Attentional biases to pain and social threat in children with recurrent abdominal pain. J Pediatr Psychol 2006;31:209-220.
  12. Chapman S, Martin M: Attention to pain words in irritable bowel syndrome: increased orienting and speeded engagement. Br J Health Psychol 2011;16:47-60.
  13. Haggman SP, Sharpe LA, Nicholas MK, Refshauge KM: Attentional biases toward sensory pain words in acute and chronic pain patients. J Pain 2010;11:1136-1145.
  14. Liossi C, Schoth DE, Bradley BP, Mogg K: Time-course of attentional bias for pain-related cues in chronic daily headache sufferers. Eur J Pain 2009;13:963-969.
  15. Schoth DE, Liossi C: Attentional bias toward pictorial representations of pain in individuals with chronic headache. Clin J Pain 2010;26:244-250.
  16. Schoth DE, Nunes VD, Liossi C: Attentional bias towards pain-related information in chronic pain; a meta-analysis of visual-probe investigations. Clin Psychol Rev 2011;32:13-25.
  17. Keogh E, Ellery D, Hunt C, Hannent I: Selective attentional bias for pain-related stimuli amongst pain fearful individuals. Pain 2001;91:91-100.
  18. Garland EL, Gaylord SA, Palsson O, Faurot K, Douglas Mann J, Whitehead WE: Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med, E-pub ahead of print.
  19. Zeidan F, Martucci KT, Kraft RA, Gordon NS, McHaffie JG, Coghill RC: Brain mechanisms supporting the modulation of pain by mindfulness meditation. J Neurosci 2011;31:5540-5548.
  20. Garland EL: The meaning of mindfulness: a second-order cybernetics of stress, metacognition, and coping. Compl Health Pract Rev 2007;12:15-30.
    External Resources
  21. Lutz A, Slagter HA, Dunne JD, Davidson RJ: Attention regulation and monitoring in meditation. Trends Cogn Sci 2008;12:163-169.
  22. Chiesa A, Calati R, Serretti A: Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clin Psychol Rev 2011;31:449-464.
  23. Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U: How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspect Psychol Sci 2011;6:537-559.
    External Resources
  24. Gootjes L, Franken IHA, Van Strien JW: Cognitive emotion regulation in yogic meditative practitioners. J Psychophysiol 2011;25:87-94.
    External Resources
  25. Sobolewski A, Holt E, Kublik E, Wróbel A: Impact of meditation on emotional processing - a visual ERP study. Neurosci Res 2011;71:44-48.
  26. Taylor V, Grant J, Daneault V, Scavone G, Breton E, Roffe-Vidal S, Courtemanche J, Lavarenne AS, Beauregard M: Impact of mindfulness on the neural responses to emotional pictures in experienced and beginner meditators. Neuroimage 2011;15:1524-1533.
  27. Garland EL, Gaylord SA, Boettiger CA, Howard MO: Mindfulness training modifies cognitive, affective, and physiological mechanisms implicated in alcohol dependence: results of a randomized controlled pilot trial. J Psychoactive Drugs 2010;42:177-192.
  28. Vago DR, Nakamura Y: Selective attentional bias towards pain-related threat in fibromyalgia: preliminary evidence for effects of mindfulness meditation training. Cog Ther Res 2011;35:1-14.
    External Resources
  29. Garland EL, Boettiger CA, Gaylord SA, West Channon V, Howard MO: Mindfulness is inversely associated with alcohol attentional bias among recovering alcohol dependent adults. Cog Ther Res 2012;36:441-450.
  30. Jha A, Krompinger J, Baime M: Mindfulness training modifies subsystems of attention. Cogn Affect Behav Neurosci 2007;7:109-119.
  31. Fava GA, Tomba E, Sonino N: Clinimetrics: the science of clinical measurements. Int J Clin Pract 2012;66:11-15.
  32. Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P, et al: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain 2009;10:113-130.
  33. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC: The Mini International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(suppl 20):22-33.
    External Resources
  34. Garland EL: Mindfulness-Oriented Recovery Enhancement for Addiction, Stress, and Pain. Washington, NASW Press, 2013.
  35. Fava GA, Ruini C: Development and characteristics of a well-being enhancing psychotherapeutic strategy: well-being therapy. J Behav Ther Exp Psychiatry 2003;34:45-63.
  36. Rawson R, McCann MJ: Counselor's Treatment Manual: Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders. Washington, SAMHSA, 2006.
  37. Cleeland CS: Brief Pain Inventory - Short Form (BPI-SF). Houston, 1994.
  38. McNeil DW, Rainwater AJ: Development of the Fear of Pain Questionnaire. J Behav Med 1998;21:389-410.
  39. MacLeod C, Mathews A: Anxiety and the allocation of attention to threat. Q J Exp Psychol A 1988;40:653-670.
  40. Lang P, Bradley M, Cuthbert B: International Affective Picture System (IAPS): Technical Manual and Affective Ratings. Gainesville, NIMH Center for the Study of Emotion and Attention, 1997.
  41. Rosenstiel AK, Keefe FJ: The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 1983;17:33-44.
  42. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L: Using self-report assessment methods to explore facets of mindfulness. Assessment 2008;15:329-342.
  43. Ratcliffe R: Methods of dealing with reaction-time outliers. Psychol Bull 1993;114:510-532.
  44. Mogg K, Bradley BP, De Bono J, Painter M: Time course of attentional bias for threat information in non-clinical anxiety. Behav Res Ther 1997;35:297-303.
  45. Little RJ: Modeling the drop-out mechanism in repeated-measures studies. J Am Stat Assoc 1995;90:1112-1121.
    External Resources
  46. Singer J, Willett J: Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. New York, Oxford University Press, 2003.
    External Resources
  47. Satterthwaite FE: An approximate distribution of estimates of variance components. Biometrics Bull 1946;2:110-114.
  48. Dehghani M, Sharpe L, Nicholas MK: Modification of attentional biases in chronic pain patients: a preliminary study. Eur J Pain 2004;8:585-594.
  49. Sharpe L, Ianiello M, Dear BF, Nicholson Perry K, Refshauge K, Nicholas MK: Is there a potential role for attention bias modification in pain patients? Results of 2 randomised, controlled trials. Pain 2012;153:722-731.

Article / Publication Details

First-Page Preview
Abstract of Regular Article

Received: September 03, 2012
Accepted: February 10, 2013
Published online: August 09, 2013
Issue release date: August 2013

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 1

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.