Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review.
Study Goal
The researchers aimed to update a systematic review and meta-analysis on the effects of acceptance- and mindfulness-based interventions (ACT, MBSR, MBCT) on mental and physical health outcomes in chronic pain patients.
Results Summary
The study found small to moderate effect sizes on pain intensity, depression, anxiety, pain interference, disability, and quality of life at post-treatment, with some effects persisting at follow-up. ACT showed significantly higher effects on depression and anxiety compared to MBSR and MBCT, but these interventions were not superior to traditional cognitive behavioral treatments.
Population
1,285 patients with chronic pain.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
acceptance- and mindfulness-based interventions | decrease | anxiety | patients with chronic pain | moderate | ranged from small to moderate | #1 |
acceptance- and mindfulness-based interventions | decrease | pain interference | patients with chronic pain | moderate | ranged from small to moderate | #2 |
acceptance- and mindfulness-based interventions | decrease | pain intensity | patients with chronic pain | small | ranged from small | #3 |
acceptance- and mindfulness-based interventions | decrease | depression | patients with chronic pain | small | ranged from small | #4 |
acceptance- and mindfulness-based interventions | decrease | disability | patients with chronic pain | small | ranged from small | #5 |
acceptance- and mindfulness-based interventions | increase | quality of life | patients with chronic pain | small | ranged from small | #6 |
acceptance- and mindfulness-based interventions | decrease | pain interference | patients with chronic pain | large | ranged from small to large | #7 |
acceptance- and mindfulness-based interventions | decrease | pain intensity | patients with chronic pain | small | ranged from small | #8 |
acceptance- and mindfulness-based interventions | decrease | disability | patients with chronic pain | small | ranged from small | #9 |
acceptance and commitment therapy (ACT) | decrease | depression | patients with chronic pain | - | showed significantly higher effects | #10 |
acceptance and commitment therapy (ACT) | decrease | anxiety | patients with chronic pain | - | showed significantly higher effects | #11 |
acceptance- and mindfulness-based interventions | no change | - | - | - | did not moderate the effects | #12 |
acceptance- and mindfulness-based interventions | neutral | - | - | - | can be good alternatives | #13 |
The number of acceptance- and mindfulness-based interventions for chronic pain, such as acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), increased in recent years. Therefore an update is warranted of our former systematic review and meta-analysis of studies that reported effects on the mental and physical health of chronic pain patients. Pubmed, EMBASE, PsycInfo and Cochrane were searched for eligible studies. Current meta-analysis only included randomized controlled trials (RCTs). Studies were rated for quality. Mean quality did not improve in recent years. Pooled standardized mean differences using the random-effect model were calculated to represent the average intervention effect and, to perform subgroup analyses. Outcome measures were pain intensity, depression, anxiety, pain interference, disability and quality of life. Included were twenty-five RCTs totaling 1285 patients with chronic pain, in which we compared acceptance- and mindfulness-based interventions to the waitlist, (medical) treatment-as-usual, and education or support control groups. Effect sizes ranged from small (on all outcome measures except anxiety and pain interference) to moderate (on anxiety and pain interference) at post-treatment and from small (on pain intensity and disability) to large (on pain interference) at follow-up. ACT showed significantly higher effects on depression and anxiety than MBSR and MBCT. Studies' quality, attrition rate, type of pain and control group, did not moderate the effects of acceptance- and mindfulness-based interventions. Current acceptance- and mindfulness-based interventions, while not superior to traditional cognitive behavioral treatments, can be good alternatives.