Clinical and psychological moderators of the effect of mindfulness-based cognitive therapy on persistent pain in women treated for primary breast cancer – explorative analyses from a randomized controlled trial

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

doi:10.1080/0284186x.2016.1268713

Cited by 26 publications

(24 citation statements)

References 26 publications

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“…Consistent with study hypotheses, both general and breast cancer-related psychological factors were higher among survivors with PBP compared to survivors without PBP. The heightened emotional distress in survivors with PBP is consistent with our own prior work and that of others using cross-sectional and longitudinal approaches to examining psychological factors associated with PBP following breast cancer surgery [4,19,22,35], as well as the broader literature on persistent pain following surgery in other clinical contexts [36]. We also found higher levels of mammographyspecific distress in survivors with PBP, which has not previously been reported and is suggestive of a broader psychological impact of PBP.…”

Section: Discussionsupporting

confidence: 90%

Persistent breast pain in post-surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress

et al. 2019

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Background: Persistent breast pain (PBP) is prevalent among breast cancer survivors and has powerful negative psychological consequences. The present study provided a first test of the hypothesis that: (a) pain catastrophizing, (b) heightened perceived risk of cancer, and (c) worry that pain indicates cancer may be independent mediating links between breast cancer survivors' experiences of PBP and heightened emotional distress. Methodology: We assessed levels of PBP and psychological factors in breast cancer survivors (Survivor Group: n ¼ 417; Stages I-IIIA; White = 88.7%; Age M ¼ 59.4 years) at their first surveillance mammogram post-surgery (6-15 months). A comparison group of women without histories of breast surgery or cancer (Non-cancer Group: n ¼ 587; White = 78.7%; Age M ¼ 57.4 years) was similarly assessed at the time of a routine screening mammogram. All women completed measures of breast pain, pain catastrophizing, perceived breast cancer risk, and worry that breast pain indicates cancer, as well as measures of emotional distress (symptoms of anxiety, symptoms of depression, and mammographyspecific distress). Analyses included race, age, BMI, education, and menopausal status as covariates, with significance set at 0.05. Results: As expected, PBP prevalence was significantly higher in the Survivor Group than in the Noncancer Group (50.6% vs. 17.5%). PBPþ survivors also had significantly higher levels of emotional distress, pain catastrophizing, mammography-specific distress, and worry that breast pain indicates cancer, compared to PBPÀ survivors. Structural equation modeling results were significant for all hypothesized mediational pathways. Interestingly, comparisons of PBPþ to PBPÀ women in the Noncancer Group showed similar results. Conclusion: These findings suggest the importance of (a) pain catastrophizing, (b) perceived breast cancer risk and, (c) worry that breast pain may indicate cancer, as potential targets for interventions aimed at reducing the negative psychological impact of PBP in post-surgery breast cancer survivors, as well as in unaffected women with PBP due to unknown reasons.

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Section: Discussionsupporting

confidence: 90%

Persistent breast pain in post-surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress

et al. 2019

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“…[12] Cancer pain, which may arise from both cancer and its treatment, leads to both physical and psychological health problems. [3] Many patients with cancer (41.5%) report chronic pain[4] and suffer from psychological symptoms such as depression[5] and lower quality of life (QoL). [6] In a survey study of individuals with cancer ( n = 1,800), 25% reported severe pain, 20% other severe symptoms, 45% severe family anxiety, 66% feelings of distress, and 19% severe problems with self-worth.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review: Mindfulness Intervention for Cancer-Related Pain

Ngamkham

Holden

Smith

2019

Asia-Pacific Journal of Oncology Nursing

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Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.

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“…Most recently, we reported the effect of MBCT on persistent pain in women treated for breast cancer, which yielded a statistically significant and robust effect of MBCT on pain intensity 9 . Furthermore, we have explored possible clinical and psychological moderators of the effect, i.e., for whom the intervention might be most efficacious, finding that higher levels of adult attachment avoidance, which is associated with deactivating strategies (e.g., suppression of distress-evoking thoughts and emotions), predicted a larger treatment gain 10 . In addition, to optimize treatment effects, it would be clinically valuable to explore 'how' this intervention may work, i.e., the intervention's active ingredients 11 .…”

Section: Introductionmentioning

confidence: 99%

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

Johannsen

O’Connor

O’Toole

et al. 2018

The Clinical Journal of Pain

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Clinical and psychological moderators of the effect of mindfulness-based cognitive therapy on persistent pain in women treated for primary breast cancer – explorative analyses from a randomized controlled trial

Abstract: Conclusion: Attachment avoidance, and potentially radiotherapy, may be clinically relevant factors for identifying the patients who may benefit most from MBCT as a pain intervention. Due to the exploratory nature of the analyses, the results should be considered preliminary.

Cited by 26 publications

References 26 publications

Persistent breast pain in post-surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress

Persistent breast pain in post-surgery breast cancer survivors and women with no history of breast surgery or cancer: associations with pain catastrophizing, perceived breast cancer risk, breast cancer worry, and emotional distress

A Systematic Review: Mindfulness Intervention for Cancer-Related Pain

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

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