Meaning-focused coping, pain, and affect: a diary study of hospitalized women with rheumatoid arthritis

Purpose

The aim of the study was to investigate the relationship between affective state, pain, and coping in hospitalized women with rheumatoid arthritis, including both between- and within-person perspectives.

Methods

Participants were 95 female patients between 24 and 82 years of age (M = 50.91; SD = 13.80). For three consecutive days, they rated each night their state affect (positive and negative), pain level, and coping strategies (emotion-, problem- and meaning-focused ones). Relations among variables were tested with a multilevel approach with time included as a covariate.

Results

Within-person meaning-focused coping suppressed the negative pain effect on emotional state, but only for positive affect (Sobel’s z = 2.07, p = .04). Moderators of the pain–affect relationship were between-person differences in pain level (B = −.23, SE = .08, t = −2.884, p = .004) and in meaning-focused coping (B = −.63, SE = .20, t = −2.097, p = .04). Specifically, suppression was significant only for patients who reported lower than sample average pain levels and for patients who reported lower than sample average use of meaning-focused strategies.

Conclusions

Findings indicated that meaning-focused coping can be a crucial strategy for keeping daily positive affect in the face of chronic pain and how this effect is modified by interindividual differences. Even if restricted to the specific context, it may inform an intervention for hospitalized women with rheumatoid arthritis.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4615666/

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Treating fibromyalgia with mindfulness-based stress reduction: results from a 3-armed randomized controlled trial.

Mindfulness-based stress reduction (MBSR) is a structured 8-week group program teaching mindfulness meditation and mindful yoga exercises. MBSR aims to help participants develop nonjudgmental awareness of moment-to-moment experience. Fibromyalgia is a clinical syndrome with chronic pain, fatigue, and insomnia as major symptoms. Efficacy of MBSR for enhanced well-being of fibromyalgia patients was investigated in a 3-armed trial, which was a follow-up to an earlier quasi-randomized investigation. A total of 177 female patients were randomized to one of the following: (1) MBSR, (2) an active control procedure controlling for nonspecific effects of MBSR, or (3) a wait list. The major outcome was health-related quality of life (HRQoL) 2 months post-treatment. Secondary outcomes were disorder-specific quality of life, depression, pain, anxiety, somatic complaints, and a proposed index of mindfulness. Of the patients, 82% completed the study. There were no significant differences between groups on primary outcome, but patients overall improved in HRQoL at short-term follow-up (P=0.004). Post hoc analyses showed that only MBSR manifested a significant pre-to-post-intervention improvement in HRQoL (P=0.02). Furthermore, multivariate analysis of secondary measures indicated modest benefits for MBSR patients. MBSR yielded significant pre-to-post-intervention improvements in 6 of 8 secondary outcome variables, the active control in 3, and the wait list in 2. In conclusion, primary outcome analyses did not support the efficacy of MBSR in fibromyalgia, although patients in the MBSR arm appeared to benefit most. Effect sizes were small compared to the earlier, quasi-randomized investigation. Several methodological aspects are discussed, e.g., patient burden, treatment preference and motivation, that may provide explanations for differences. In a 3-armed randomized controlled trial in female patients suffering from fibromyalgia, patients benefited modestly from a mindfulness-based stress reduction intervention.

 

https://www.ncbi.nlm.nih.gov/pubmed/21146930

ALTERED DEFAULT MODE NETWORK (DMN) RESTING STATE FUNCTIONAL CONNECTIVITY FOLLOWING A MINDFULNESS-BASED EXPOSURE THERAPY FOR POSTTRAUMATIC STRESS DISORDER (PTSD) IN COMBAT VETERANS OF AFGHANISTAN AND IRAQ.

Depress Anxiety. 2016 Apr;33(4):289-99. doi: 10.1002/da.22481.

King AP1,2, Block SR1,2,3, Sripada RK2,4, Rauch S5, Giardino N2, Favorite T1,2,6, Angstadt M2, Kessler D2, Welsh R1,7, Liberzon I1,2,3.

Increased connectivity between DMN and executive control regions following mindfulness training could underlie increased capacity for volitional shifting of attention. The increased PCC-DLPFC rsFC following MBET was related to PTSD symptom improvement, pointing to a potential therapeutic mechanism of mindfulness-based therapies.

https://www.ncbi.nlm.nih.gov/pubmed/27038410

The Development and Validation of a Scale to Measure Self-Compassion

Self and Identity

Volume 2, 2003 – Issue 3

This article defines the construct of self-compassion and describes the development of the Self-Compassion Scale. Self-compassion entails being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical; perceiving one’s experiences as part of the larger human experience rather than seeing them as isolating; and holding painful thoughts and feelings in mindful awareness rather than over-identifying with them. Evidence for the validity and reliability of the scale is presented in a series of studies. Results indicate that self-compassion is significantly correlated with positive mental health outcomes such as less depression and anxiety and greater life satisfaction. Evidence is also provided for the discriminant validity of the scale, including with regard to self-esteem measures.

Self-compassion, self-regulation, and health

Self and Identity

Volume 10, 2011 – Issue 3: Self- and identity-regulation and health

 

Self-compassion—treating oneself with kindness, care, and concern in the face of negative life events—may promote the successful self-regulation of health-related behaviors. Self-compassion can promote self-regulation by lowering defensiveness, reducing the emotional states and self-blame that interfere with self-regulation, and increasing compliance with medical recommendations. Furthermore, because they cope better with stressful events, people high in self-compassion may be less depleted by illness and injury and, thus, have greater self-regulatory resources to devote to self-care. Framing medical problems and their treatment in ways that foster self-compassion may enhance people’s ability to manage their health-related behavior and deal with medical problems.

Meta-Analysis of Gender Differences in Self-Compassion

Self and Identity

Volume 14, 2015 – Issue 5

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While research suggests strong associations of self-compassion with mental health and well-being, gender norms may hinder the development of self-compassion by women on one hand, and men on the other. This study represents one of the first systematic analyses of potential gender differences in self-compassion using meta-analytic techniques, including whether such gender differences are moderated by age or ethnic minority status. Fixed-effects models were used to estimate the average effect size (ES) of gender differences in self-compassion scores across 71 journal articles and dissertations providing a total of 88 estimates. Results revealed that males had slightly higher levels of self-compassion than females, with a small ES observed (d = .18). This difference was larger in samples with a higher percentage of ethnic minorities. Researchers and practitioners should take these group differences into account in future studies and interventions focused on self-compassion, while not overemphasizing gender differences in self-compassion as being large in size.