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
RCT OA: closed CC0 ⤵ 7 in-corpus citations
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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 (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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