BackgroundMindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.ObjectivesTherefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.MethodsA clinical trial was conducted in 2017 - 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis.ResultsStatistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.ConclusionsMBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

BackgroundPrimary headaches are the most common cause of absence from work and school and one of the most common reasons for referring to the neurologists.ObjectivesThe present study was designed to investigate the relationship of cognitive processing style and mindfulness with pain intensity and the ultimate aim was to provide the role of pain-related cognitive processes and mindfulness in the prediction of headache intensity.MethodsThe study was conducted descriptively by using the correlation method. The statistical population of this study was composed of 85 patients (56 females and 29 males) with one type of primary headache, which were selected through purposive sampling after the diagnosis of a headache by a neurologist at Imam Hossein Hospital in Tehran province. To measure the variables of the study, the numeric pain rating scale (NRS) and the pain-related cognitive processes questionnaire (PCPQ) were used. All data were analyzed using descriptive statistics (frequency and percentages). Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used.ResultsThe results showed that there was a significant and negative association between pain intensity (NRS) and mindfulness (P < 0.01) and all pain-related cognitive processes, except pain focus (P < 0.01). The results of stepwise linear regression indicated that mindfulness only explains 39% of total score changes in pain intensity (P < 0.05 and ΔF (1 and 83) = 53.63, ΔR = 0.385). Adding cognitive processing styles to the model led to an 18% increase of the explained variance (R2 change = 0.179). In total, the present research model justifies 54% of the severity of headache variance (P < 0.01, ΔR = 0.54).ConclusionsThe results suggest that pain-related cognitive processes and mindfulness are effective on pain intensity prediction. In other words, this result can explain the role of mindfulness and adaptive cognitive processing in primary headache pain management.

BackgroundPrimary headaches are one of the most troubled chronic diseases. Headaches interfere within the various dimensions of the patient’s life. Coping strategies that aim to be attention focused (e.g., mindfulness) may moderate pain-related emotional and physical interference.ObjectivesThis investigation examined the relationship between mindfulness and pain intensity with physical and emotional interference and the subsequent aim was to analyze the role of mindfulness and headache severity combination in the prediction of pain-related interference.MethodsThis correlational study was conducted during years 2017 to 2018 at Imam Hossein Hospital of Tehran province. Eighty-five patients (56 females and 29 males), who had one type of primary headache were selected through purposive sampling after the diagnosis by a neurologist. The data were collected through the brief pain inventory (BPI) and the mindful attention awareness scale (MAAS). All data were analyzed using descriptive statistics. Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used.ResultsThe correlational analysis of the results indicated significant association between mindfulness (MAAS) and pain severity (BPI) (P < 0.01) as well as the findings of the study point to the significant relationship between mindfulness and both physical and emotional pain-related interference (P < 0.01). The results of stepwise linear regression indicated that pain severity explains only 1% of the total score in emotional pain-related interference (P = 0.003 and ΔF (1 and 83) = 9.22, ΔR2 = 0.11). Adding mindfulness to the model led to a 43% increase of the explained variance (R2 Change = 0.34). In physical interference, although pain severity was able to predict pain interference (P = 0.01 and ΔF (1 and 83) = 7.09, ΔR2 = 0.07), a combination model justifies 10% of the interference variance that was not statistically meaningful (P = 0.08, ΔR2 = 0.103).ConclusionsThis result is a further support that Mindful Awareness contributed to emotional pain-related interference prediction. This result can explain the role of attention focused and mindful awareness in primary headache pain adjustment.

Background: In the “treating to target” strategy to rheumatoid arthritis (RA) management, “cognitive” beyond “physical” measures allow a more comprehensive assessment. This study reports a predictive analysis of patient properties on Disease Activity, and the degree to which these predictions could be uniquely attributable to Illness perception (IP), pain, and sex differences. Methods: This cross-sectional study was conducted in 108 patients with Rheumatoid Arthritis aged 18 to 65 years old, selected via convenience sampling. Measurements were collected using Disease Activity Score in 28 Joints (DAS28), patient's illness perception (IPQ-R), and numerical rating scale (NRS) for perceived pain. Data were analyzed applying Spearman and Pearson correlation coefficients and multiple stepwise regression (MSR) analyzes. Results: In correlation analysis, sex- Disease Activity association (.40**, P<0.01), Pain-Disease Activity association (.54**, P<0.01) were found. Additionally, we observed stronger and significant associations between IPQ-R subscales and Disease Activity [Identity (r =.53**, P<0.01) Personal control (r = -.40**, P<0.01) and Emotional representation (r =.36**, P<0.01)]. Regression analysis showed sex differences was a not significant predictor and perceived pain and three IPQ-R items (Identity, Personal control and Emotional representation) emerged as the strongest predictors (P<0.001). Conclusion: Disease Activity predicted by pain and three Illness perception items. By identifying the components affecting Disease Activity, the therapist can adjust complementary treatment according to patients' needs.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory polyarthritis with multiple clinical symptoms and psychological problems, such as depression. Psychotherapy can play an important role in achieving therapeutic goals. Objective: The purpose of this study was to determine the effect of cognitive behavioral therapy for adherence, depression (CBT-AD) and negative illness representations in people with RA. Methods: A clinical trial was conducted in Rheumatology's clinic in a Shariaty hospital in Tehran during 2016-2017, Iran. Then, among 151 patients with rheumatoid arthritis, 28 patient were selected using the sampling judgment and half of them were randomly assigned to the CBT-AD (14 patients) and the others were in the control group (14 patients). Psychological questionnaires including the illness perception questionnaire-revised, beck depression inventory and general adherence Scale were measured. All data were analyzed by independent ttest, Chi-square and multivariate covariance analysis. Findings: The results showed that the baseline, post-test score between two intervention and control groups in three dimensions of illness representations (P<0.001), depression (P<0.001) and adherence (P<0.001) were statistically significant. Conclusion: CBT-AD is a potentially efficacious approach for individuals with RA struggling with depression at the same time, which leads to a reduction in depression, an increase in adherence and correction of negative illness representations.