Department of Psychology, Bar-Ilan University, Ramat Gan, 5290002, Israel.
Clinical Immunology, Angioedema and Allergy, Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, 52621, Israel.
Complement Ther Clin Pract. 2024 Aug;56:101860. doi: 10.1016/j.ctcp.2024.101860. Epub 2024 Apr 16.
Fibromyalgia (FM) is a pain condition characterized by physical and psychological difficulties. This randomized controlled trial aimed to evaluate the effects of a mindfulness-based stress reduction (MBSR) on FM patients and identify the role of two pain cognitions: psychological inflexibility in pain (PIPS) and pain catastrophizing (PCS), as mechanisms of change.
95 FM patients (Mean ± SD: 49.18 ± 13.26 years) were randomly assigned to MBSR group therapy (n = 49) or a waitlist (WL) control group (n = 46). An adapted MBSR protocol for FM was employed. A series of measures were taken, covering FM symptoms, depression, perceived stress (PSS), PIPS and PCS. Three measurements were conducted: pre-intervention, post-intervention and 6-months follow up.
Compared to WL controls, the MBSR group showed greater improvements in FM symptoms (F(1,78) = 2.81, p < 0.05), PSS (F(1,78) = 4.38, p < 0.05) and Depression (F(1,78) = 21.12, p < 0.001), with mostly medium effect sizes. Improvements in PSS (F(2,68) = 7.75, p < 0.05) and depression (F(2,68) = 15.68, p < 0.05) remained stable over six months. The effect of MBSR on FM and PSS was mediated by one's reported change in PIPS. The effect of MBSR on depression was mediated by one's reported change in PCS.
These results reveal the significant therapeutic potential of MBSR for FM patients, due to the emphasis on non-judging and acceptance of negative inner states. Furthermore, this research identified two important pain-related cognitions as mechanisms of change, suggesting that MBSR contributes to cognitive change, which enables the reduction of physical and psychological distress.
NCT04304664.
纤维肌痛（FM）是一种以身体和心理困难为特征的疼痛病症。本随机对照试验旨在评估基于正念的应激减轻（MBSR）对 FM 患者的影响，并确定两种疼痛认知的作用：疼痛中的心理不灵活性（PIPS）和疼痛灾难化（PCS），作为变化的机制。
95 名 FM 患者（均值±标准差：49.18±13.26 岁）被随机分配到 MBSR 组治疗（n=49）或候补名单（WL）对照组（n=46）。采用改良的 FM 适应 MBSR 方案。进行了一系列测量，涵盖 FM 症状、抑郁、感知压力（PSS）、PIPS 和 PCS。进行了三次测量：干预前、干预后和 6 个月随访。
与 WL 对照组相比，MBSR 组在 FM 症状（F（1,78）=2.81，p<0.05）、PSS（F（1,78）=4.38，p<0.05）和抑郁（F（1,78）=21.12，p<0.001）方面的改善更大，具有中等的效果大小。PSS（F（2,68）=7.75，p<0.05）和抑郁（F（2,68）=15.68，p<0.05）在六个月内保持稳定。MBSR 对 FM 和 PSS 的影响是通过报告的 PIPS 变化来介导的。MBSR 对抑郁的影响是通过报告的 PCS 变化来介导的。
这些结果表明 MBSR 对 FM 患者具有显著的治疗潜力，因为它强调对消极内在状态的不评判和接纳。此外，这项研究确定了两种重要的与疼痛相关的认知作为变化的机制，表明 MBSR 有助于认知的改变，从而减轻身体和心理的痛苦。
NCT04304664。
