Mindfulness-based Cognitive Therapy and Persistent Pain in Women Treated for Primary Breast Cancer

Johannsen, Maja; O’Connor, Maja; O’Toole, Mia Skytte; Jensen, Anders Bonde; Zachariae, Robert

doi:10.1097/ajp.0000000000000510

Cited by 33 publications

(27 citation statements)

References 45 publications

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“…In explaining pain openness processes (including cognitive processes with acceptance and without judgment) and long-standing changes in MBCT, it can be stated that during MBCT sessions, participants learned to accept the pain condition and this gave them the opportunity for responding without judgment instead of surrendering to negative beliefs about pain (13). Other authors obtained similar results in pain openness processing (30, 31).…”

Section: Discussionsupporting

confidence: 76%

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 76%

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group

et al. 2019

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“…Patients indicated on 11‐point numerical rating scales (0 = not at all, 10 = very much) “Within the past week, how depressed and sad have you been?” and “Within the past week, how worried and anxious have you been?”. The 3‐point cut‐off was based on our experiences with similar recruitment procedures …”

Section: Methodsmentioning

confidence: 99%

“…Breast and prostate cancer were chosen as they are prevalent cancer types with high long‐term survival rates . We chose iMBCT as our group has previously found MBCT to be well‐accepted and efficacious for treating persistent pain in breast cancer survivors . We compared iMBCT with waitlist CAU controls at post intervention and 6 months follow‐up.…”

Section: Introductionmentioning

confidence: 99%

Internet‐delivered mindfulness‐based cognitive therapy for anxiety and depression in cancer survivors: A randomized controlled trial

et al. 2019

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Objective: Internet-delivered interventions may alleviate distress in cancer survivors with limited access to psychological face-to-face treatment. In collaboration with a group of cancer survivors, we developed and tested the efficacy of a therapistassisted internet-delivered mindfulness-based cognitive therapy (iMBCT) program for anxiety and depression in cancer survivors. Methods:A total of 1282 cancer survivors were screened for anxiety and depression during their routine oncology follow-up; eligible breast (n = 137) and prostate cancer (n = 13) survivors were randomized to iMBCT or care-as-usual (CAU) wait-list.Primary outcomes of anxiety and depression were assessed at baseline, 5 weeks, 10 weeks (post intervention), and 6 months.Results: Significant effects were found for both anxiety (Cohen's d = 0.45; P = .017) and depressive symptoms (d = 0.42; P = .024) post intervention. The effects were maintained at follow-up for anxiety (d = 0.40; P = .029), but not for depressive symptoms (d = 0.28; P = .131). Conclusions:Our preliminary findings suggest iMBCT to be a helpful intervention for cancer survivors suffering from symptoms of anxiety. Further studies on the efficacy for symptoms of depression are needed.

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“…Pain catastrophizing comprises of rumination, magnification and helplessness, and has been identified as an important treatment mediator of mindfulness-based cognitive therapy on pain intensity in women treated for primary breast cancer. 33 Women with persistent pain following breast cancer surgery can show high levels of pain catastrophizing that mediate alterations in central pain modulatory systems. 34 Indeed, when comparing post-mastectomy patients with and without post-surgical pain, they did not differ in treatment or disease-related variables, but differed in terms of psychological factors (more anxiety, catastrophizing, depression and somatization in the patients having pain).…”

Section: Itemmentioning

confidence: 99%

“…Finally, systematic evaluation of the effects of exercise on a multitude of cancer-related concerns, e.g., fatigue, sleep and mood reveals it is effective for these impairments, but also shows some efficacy for decreasing pain in this population. 67 Pain beliefs such as pain catastrophizing, 33,68 fear of movement 69 and fear of cancer (recurrence) can prevent patients following cancer of returning to normal physical activity levels or limit effect sizes of exercise interventions. Therefore, at the end of the PNE, the patient should be able to put their post-cancer pain into the right perspective and feel less threatened by the pain, leading to the willingness to perform physical activity with progression toward feared or avoided movements.…”

Section: Learning Objectivesmentioning

confidence: 99%

Explaining pain following cancer: a practical guide for clinicians

Nijs

Wijma

Leysen

et al. 2019

Brazilian Journal of Physical Therapy

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Background: Pain is one of the most prevalent and debilitating symptom following cancer treatment. Objectives: This paper entails a practical guide for clinicians willing to apply pain neuroscience education (PNE) in this specific population, or clinical researchers willing to examine the effects of PNE in patients suffering from pain following cancer. Results: Patient-specific information (i.e. beliefs, cognitions, pain memories, social factors) as well as identification of the dominant pain mechanism are needed to tailor the education to the specific needs and beliefs of the patient. Therapists require an in-depth understanding of pain mechanisms, the skills to explain to their patients various pain mechanisms, specific communication skills (e.g. Socratic-style dialogof education) and experience with current evidence-based biopsychosocially-driven pain management strategies for successful implementation of PNE in the clinic. Rather than purely focusing on the biomedical characteristics of pain following cancer (e.g., tissue damage due to past cancer treatment), PNE implies teaching patients about the underlying biopsychosocial mechanisms of pain. Its application is backed-up by mounting evidence supporting the effectiveness of PNE in non-cancer pain populations, and a pilot study in patients having pain following cancer. Conclusion: PNE is a potential solution to improve pain outcome in cancer survivors. Further research using sufficiently powered and well-designed randomized clinical trials should be conducted to examine the potential of PNE in patients having pain following cancer.

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Mindfulness-based Cognitive Therapy and Persistent Pain in Women Treated for Primary Breast Cancer

Abstract: The results of the present study may have clinical implications. An increased focus on the proposed mediators may optimize the clinical use of MBCT for persistent pain in women treated for breast cancer.

Cited by 33 publications

References 45 publications

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group

Internet‐delivered mindfulness‐based cognitive therapy for anxiety and depression in cancer survivors: A randomized controlled trial

Explaining pain following cancer: a practical guide for clinicians

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