Brief mindfulness training can mitigate the influence of prior expectations on pain perception

Author: S Vencatachellum1, M van der Meulen1, D M L Van Ryckeghem1,2,3, S Van Damme3, C Vögele1
1 Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Grand-Duchy of Luxembourg.
2 Experimental Health Psychology and Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands.
3 Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
Conference/Journal: Eur J Pain
Date published: 2021 Jun 8
Other: Special Notes: doi: 10.1002/ejp.1817. , Word Count: 234

Recent neuroimaging evidence suggests that mindfulness practice may mitigate the biasing influence of prior cognitive and emotional expectations on pain perception. The current study tested this hypothesis using a pain-cueing paradigm, which has reliably been shown to elicit conditioned hypoalgesic and hyperalgesic effects. Specifically, we aimed to investigate whether the instructed use of a mindfulness compared to a suppression strategy differentially modulates the magnitudes of conditioned hypoalgesia and hyperalgesia.

Sixty-two healthy non-meditators were assigned to listen to either brief mindfulness or suppression instructions, in between the conditioning and testing phases of a pain-cueing task. Participants provided ratings of anticipatory anxiety, pain intensity and pain unpleasantness throughout the task. They also completed trait and state self-report measures of mindfulness and pain catastrophizing.

Results indicated that the paradigm was successful in inducing conditioned hyperalgesic and hypoalgesic effects. Importantly, while we found evidence of cue-induced hyperalgesia in both groups, only the suppression group reported cue-induced hypoalgesia. No group differences in pain ratings were found for unconditioned (novel-cued) stimuli.

These findings provide partial support for recently proposed predictive processing models, which posit that mindfulness may lead to a prioritisation of current sensory information over previous expectations. We explore potential explanations for the asymmetrical group differences in conditioned hypoalgesia vs. conditioned hyperalgesia, and discuss our results in light of recent neuroimaging insights into the neuropsychological mechanisms of mindfulness and expectancy-driven pain modulation.

PMID: 34101937 DOI: 10.1002/ejp.1817