Dispositional Mindfulness and Acute Heat Pain: Comparing Stimulus-Evoked Pain With Summary Pain Assessment

Author: Dominik Mischkowski1, Caitlin M Stavish, Esther E Palacios-Barrios, Lauren A Banker, Troy C Dildine, Lauren Y Atlas
Affiliation: <sup>1</sup> From the Department of Psychology (Mischkowski) and Ohio Musculoskeletal and Neurological Institute (Mischkowski), Ohio University, Athens, Ohio; Department of Psychology (Stavish), University of Washington, Seattle, Washington; National Institute of Mental Health, National Institutes of Health (Atlas), Bethesda, Maryland; Department of Psychology (Palacios-Barrios), University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Applied Physiology and Kinesiology (Banker), University of Florida, Gainesville, Florida; National Center for Complementary and Integrative Health, National Institutes of Health (Dildine, Atlas), Bethesda, Maryland; Department of Clinical Neuroscience (Dildine), Karolinska Institutet, Solna, Sweden; and National Institute on Drug Abuse, National Institutes of Health (Atlas), Baltimore, Maryland.
Conference/Journal: Psychosom Med
Date published: 2021 Jul-Aug 01
Other: Volume ID: 83 , Issue ID: 6 , Pages: 539-548 , Special Notes: doi: 10.1097/PSY.0000000000000911. , Word Count: 257


Objective:
Dispositional mindfulness is associated with reduced pain in clinical and experimental settings. However, researchers have neglected the type of pain assessment, as dispositional mindfulness may have unique benefits for reduced pain sensitivity when relying on summary pain assessments, in contrast to assessing the pain of each noxious stimulus. Here, we test the association between dispositional mindfulness and pain using both trial-by-trial pain assessments and overall summary ratings after acute pain tasks.

Methods:
One hundred thirty-one healthy adult volunteers (mean age = 29.09 [8.00] years, 55.7% female) underwent two experimental thermal pain paradigms. We tested whether dispositional mindfulness measured with the Mindful Attention Awareness Scale was related to a) heat-evoked pain sensitivity, as measured by pain threshold, pain tolerance, average pain, trial-by-trial ratings, and heat-evoked skin conductance response, and b) summary judgments of sensory and affective pain assessed using the McGill Pain Questionnaire (MPQ).

Results:
Mindful Attention Awareness Scale ratings were associated with decreased pain on the MPQ sensory (B = -0.18, SE = 0.05, 95% confidence interval = -0.29 to -0.07, t = -3.28, p = .001) and affective (B = -0.11, SE = 0.03, 95% confidence interval = -0.18 to -0.05, t = -3.32, p = .001) dimensions but not with experimental thermal pain assessments, including threshold, tolerance, heat-evoked pain, or skin conductance response (p values ≥ .29).

Conclusions:
In this study, dispositional mindfulness mitigated acute thermal pain only when pain was assessed using the MPQ. These findings may reflect differences in immediate versus retrospective judgments or the type of pain assessed by each measure. Future research should examine regulation processes that may explain these differential analgesic benefits, such as attention, rumination, or reappraisal.


PMID: 34213859 DOI: 10.1097/PSY.0000000000000911