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Mindfulness-based interventions and hypnosis are efficacious treatments for addressing a large number of psychological and physical conditions, including chronic pain. However, there continues to be debate surrounding the relative uniqueness of the theorized mechanisms of these treatments – reflected by measures of mindfulness facets and hypnotizability – with some concern that there may be so much overlap as to make the mechanism constructs (and therefore the respective interventions) redundant. Given these considerations, the primary aim of the current study was to examine the degree of unique versus shared variance between two common measures of mindfulness facets and hypnotizability: the Five Facet Mindfulness Questionnaire (FFMQ) and the Stanford Hypnotic Clinical Scale (SHCS). A cross-sectional survey was conducted with a sample of N=154 Veterans with heterogeneous chronic pain conditions. Bivariate Pearson correlations were used to examine the associations between the target scales. Results showed that the correlations between the FFMQ scales and SHCS total score were uniformly weak, although significant negative correlations were found between mindfulness facets of observe and non-react with hypnotizability (ps < .05). Thus, not only are the mindfulness and hypnotizability constructs unique, but when significantly associated, hypnotic suggestibility corresponds with a tendency to be less mindful. These findings have important implications for future research aimed towards matching patients to the treatment most likely to be of benefit, and suggest that matching patients on the basis of these theoretically derived “unique” moderators may hold potential.

Background This study reports a multivariate test of sex and race differences in experimental pain, and the degree to which these differences could be uniquely attributable to three levels of cognition: primary appraisals (threat, challenge), secondary appraisals (pain catastrophizing) and/or cognitive processes (mindful observing, non‐reactivity). Both the predictive and mediator role of the cognitive variables was of interest. Methods The study employed a cross‐sectional experimental design, with the cold pressor task employed as the pain stimulus. The total sample included N = 355 healthy adults (67% female, 33% male; 70% Caucasian, 30% Asian). Results Significant sex and race differences on pain tolerance were found, with females and racial minorities reporting less pain tolerance (ps < 0.001). Males reported significantly higher challenge appraisals and non‐reactivity, and lower pain catastrophizing than females; Asians reported significantly higher threat appraisals and pain catastrophizing than Caucasians. In multivariate analyses, challenge appraisals and non‐reactivity emerged as the strongest predictors of pain tolerance. Furthermore, challenge appraisals mediated the sex‐pain tolerance association (p = .017). Conclusions This study showed that race and sex differences, at least in part, may be accounted for by differences in pain‐related cognitions. Significance The three levels of cognition investigated in this research represent changeable, important processes for potentially mitigating the impact of pain in vulnerable groups.

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