The Influence of Pain Avoidance on the Experience of Mindfulness Training

Research on mindfulness training indicates that it is associated with more positive psychological outcomes. Conversely, research on avoidance as a means of coping with chronic pain is associated with negative psychological outcomes. This study utilized a randomized experimental design and introduced participants to either a novel form of meditation (a mindfulness body scan, which was a shortened version of the body scan taught in Mindfulness Based Stress Reduction (MBSR) training) or an opportunity to listen to a description of mindfulness. Data was collected electronically. Mindfulness was measured by the Mindful Attention and Awareness Scale (MAAS), and the Toronto Mindfulness Scale (TMS). Pain Avoidance was measured by the Psychological Inflexibility in Pain Scale (PIPS), and pain ratings were recorded using a Visual Analog Scale (VAS). T-tests compared means of pre/post measures of mindfulness and pain ratings. Correlational analysis explored relationships of avoidance, mindfulness and pain ratings. A moderated mediational model was proposed that assumed change in mindfulness mediated the pathway between treatment effect and change in pain ratings. Linear regression was used to determine pain avoidance as a significant moderating variable in the relationship between treatment effect and change in mindfulness. Both control and experimental groups experienced a significant increase in mindfulness and a significant decrease in pain ratings from pre to post intervention. Results revealed that change in mindfulness did not enhance the strength of the relationship between treatment effect and change in pain ratings. There was an unexpected multicollinearity between pain avoidance and mindfulness, and no treatment X pain avoidance interaction; pain avoidance and pre intervention level of mindfulness were both significant predictor variables for post intervention level of mindfulness. Unexpected positive correlation between pain avoidance and mindfulness is explored and recommendations for future research are proposed.