HHS Public Access Author manuscript Author Manuscript
Pain. Author manuscript; available in PMC 2017 November 01. Published in final edited form as: Pain. 2016 November ; 157(11): 2434–2444. doi:10.1097/j.pain.0000000000000635.
Mindfulness-based stress reduction and cognitive-behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial
Author Manuscript
Judith A. Turnera,*, Melissa L. Andersonb, Benjamin H. Baldersonb, Andrea J. Cookb, Karen J. Shermanb, and Daniel C. Cherkinb a
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA b
Group Health Research Institute, Seattle, Washington, USA
Abstract
Author Manuscript
Cognitive-behavioral therapy (CBT) is believed to improve chronic pain problems by decreasing patient catastrophizing and increasing patient self-efficacy for managing pain. Mindfulness-based stress reduction (MBSR) is believed to benefit chronic pain patients by increasing mindfulness and pain acceptance. However, little is known about how these therapeutic mechanism variables relate to each other or whether they are differentially impacted by MBSR versus CBT. In a randomized controlled trial comparing MBSR, CBT, and usual care (UC) for adults aged 20-70 years with chronic low back pain (CLBP) (N = 342), we examined (1) baseline relationships among measures of catastrophizing, self-efficacy, acceptance, and mindfulness; and (2) changes on these measures in the 3 treatment groups. At baseline, catastrophizing was associated negatively with self-efficacy, acceptance, and 3 aspects of mindfulness (non-reactivity, non-judging, and acting with awareness; all P-values
Pain. Author manuscript; available in PMC 2017 November 01. Published in final edited form as: Pain. 2016 November ; 157(11): 2434–2444. doi:10.1097/j.pain.0000000000000635.
Mindfulness-based stress reduction and cognitive-behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial
Author Manuscript
Judith A. Turnera,*, Melissa L. Andersonb, Benjamin H. Baldersonb, Andrea J. Cookb, Karen J. Shermanb, and Daniel C. Cherkinb a
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA b
Group Health Research Institute, Seattle, Washington, USA
Abstract
Author Manuscript
Cognitive-behavioral therapy (CBT) is believed to improve chronic pain problems by decreasing patient catastrophizing and increasing patient self-efficacy for managing pain. Mindfulness-based stress reduction (MBSR) is believed to benefit chronic pain patients by increasing mindfulness and pain acceptance. However, little is known about how these therapeutic mechanism variables relate to each other or whether they are differentially impacted by MBSR versus CBT. In a randomized controlled trial comparing MBSR, CBT, and usual care (UC) for adults aged 20-70 years with chronic low back pain (CLBP) (N = 342), we examined (1) baseline relationships among measures of catastrophizing, self-efficacy, acceptance, and mindfulness; and (2) changes on these measures in the 3 treatment groups. At baseline, catastrophizing was associated negatively with self-efficacy, acceptance, and 3 aspects of mindfulness (non-reactivity, non-judging, and acting with awareness; all P-values
