Cognitive-affective changes mediate the mindfulness-based intervention effect on endometriosis-related pain and mental health: A path analysis approach

De França Moreira, Marcelo, Gamboa OL, Olga Lucia Gamboa, Olga Lucía Gamboa, Marco Aurélio Pinho Oliveira
European journal of pain (London, England) · 2023 · vol. 27(10) , pp. 1187–1202 · doi:10.1002/ejp.2149 · PMID:37365715 · W4382182392
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A mindfulness-based intervention improved endometriosis pain and mental health by reducing pain catastrophizing and increasing positive affect, with mental health benefits also mediated by reduced negative affect.

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Abstract

BACKGROUND: There is poor knowledge about the therapeutic mechanisms of the conservative interventions for endometriosis. We hypothesized that the effects of a brief mindfulness-based intervention (bMBI) on pelvic pain intensity (PPI), pain unpleasantness (PU) and quality of life mental health (QoL-MH) are mediated by direct and indirect paths of changes in pain catastrophizing (PC), positive affect (PA) and negative affect (NA). METHODS: A secondary analysis of a pilot randomized controlled trial of women with endometriosis, assigned to standard medical treatment (n = 32) and standard medical treatment plus bMBI (n = 31). We tested a series of parallel and serial mediators (PC, PA and NA) of the relationship between bMBI and outcomes (PPI, PU and QoL-MH). RESULTS: The bMBI group demonstrated improvement in PA (Cohen's f2  = 0.12 [0.01, 0.36]), decreases in NA (Cohen's f2  = 0.06 [0.00, 0.24]) and PC (Cohen's f2  = 0.16 [0.02, 0.42]). The PC reduction mediated the effect of the bMBI on PPI and PU directly; however, the PC effect through PA increase mediated the PU marginally but not PPI changes. bMBI effect on Qol-MH was mediated directly by PA and NA. The PC improved Qol-MH through PA increase and Pain decrease but not via NA. CONCLUSIONS: Our findings showed that bMBI impacts pain through changes in pain-related cognitive-affective factors. bMBI can improve QoL-MH by multiple pathways, including but not limited to pain reduction, highlighting the independent potential of improvement in affect to restore mental health in endometriosis. SIGNIFICANCE: Brief mindfulness-based intervention improves endometriosis pain through pain-related cognitive-affective factors and quality of life mental health via pain and affect changes unrelated to pain.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect Affect

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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