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Published in: Clinical Rheumatology 6/2019

01-06-2019 | Affective Disorder | Original Article

Mindfulness is associated with psychological health and moderates the impact of fibromyalgia

Authors: Brandon Pleman, Michelle Park, Xingyi Han, Lori Lyn Price, Raveendhara R. Bannuru, William F. Harvey, Jeffrey B. Driban, Chenchen Wang

Published in: Clinical Rheumatology | Issue 6/2019

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Abstract

Objective

Previous studies suggest mindfulness is associated with pain and depression. However, its impact in individuals with fibromyalgia remains unclear. We examined associations between mindfulness and physical and psychological symptoms, pain interference, and quality of life in fibromyalgia patients.

Methods

We performed a cross-sectional analysis on baseline data from a fibromyalgia clinical trial. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire (FFMQ). Pearson’s correlations and multivariable linear regression models were used to evaluate associations between mindfulness and fibromyalgia impact, pain interference, physical function, depression, anxiety, stress, self-efficacy, and health-related quality of life. We also examined whether mindfulness moderated associations between fibromyalgia impact and psychological outcomes.

Results

A total of 177 participants (age 52.0 ± 12.2 (SD) years; 93.2% women; 58.8% white; body mass index 30.1 ± 6.7 kg/m2; FFMQ score 131.3 ± 20.7; Revised Fibromyalgia Impact Questionnaire score 57.0 ± 19.4) were included. Higher total mindfulness was significantly associated with lower fibromyalgia impact (r = − 0.25), pain interference (r = − 0.31), stress (r = − 0.56), anxiety (r = − 0.58), depression (r = − 0.54), and better mental health-related quality of life (r = 0.57). Describing, Acting-with-awareness, and Non-judging facets of mindfulness were also associated with these outcomes. Mindfulness moderated the effect of fibromyalgia impact on anxiety (interaction P = 0.01).

Conclusion

Higher mindfulness is associated with less pain interference, lower impact of fibromyalgia, and better psychological health and quality of life in people with fibromyalgia. Mindfulness moderates the influence of fibromyalgia impact on anxiety, suggesting mindfulness may alter how patients cope with fibromyalgia. Future studies should assess how mind-body therapies aiming to cultivate mindfulness may impact the well-being of patients with fibromyalgia.

Key points

• Higher mindfulness was associated with better psychological health and lower overall impact of fibromyalgia.
• Mindfulness moderated the relationship between overall fibromyalgia impact and anxiety.
Literature
2.
go back to reference Burckhardt CS, Clark SR, Bennett RM (1993) Fibromyalgia and quality of life: a comparative analysis. J Rheumatol 20:475–479PubMed Burckhardt CS, Clark SR, Bennett RM (1993) Fibromyalgia and quality of life: a comparative analysis. J Rheumatol 20:475–479PubMed
3.
go back to reference Sephton SE, Paul S, Weissbecker I, Ulmer C, Floyd A, Hoover K et al (2007) Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial. Arthritis Rheum 57:77–85CrossRefPubMed Sephton SE, Paul S, Weissbecker I, Ulmer C, Floyd A, Hoover K et al (2007) Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial. Arthritis Rheum 57:77–85CrossRefPubMed
4.
go back to reference Schütze R, Rees C, Preece M, Schütze M (2010) Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain. Pain 148:120–127CrossRefPubMed Schütze R, Rees C, Preece M, Schütze M (2010) Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain. Pain 148:120–127CrossRefPubMed
5.
go back to reference Baer RA, Smith GT, Lykins E, Button D, Krietemeyer J, Sauer S et al (2008) Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment 15:329–342CrossRef Baer RA, Smith GT, Lykins E, Button D, Krietemeyer J, Sauer S et al (2008) Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment 15:329–342CrossRef
6.
go back to reference Bränström R, Duncan LG, Moskowitz JT (2011) The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. Br J Health Psychol 16:300–316CrossRefPubMedPubMedCentral Bränström R, Duncan LG, Moskowitz JT (2011) The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. Br J Health Psychol 16:300–316CrossRefPubMedPubMedCentral
7.
go back to reference Bränström R, Kvillemo P, Brandberg Y, Moskowitz JT (2010) Self-report mindfulness as a mediator of psychological well-being in a stress reduction intervention for cancer patients--a randomized study. Ann Behav Med 39:151–161CrossRefPubMed Bränström R, Kvillemo P, Brandberg Y, Moskowitz JT (2010) Self-report mindfulness as a mediator of psychological well-being in a stress reduction intervention for cancer patients--a randomized study. Ann Behav Med 39:151–161CrossRefPubMed
8.
go back to reference Lee AC, Harvey WF, Price LL, Morgan LPK, Morgan NL, Wang C (2017) Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis. Osteoarthr Cartil 25:824–831CrossRefPubMed Lee AC, Harvey WF, Price LL, Morgan LPK, Morgan NL, Wang C (2017) Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis. Osteoarthr Cartil 25:824–831CrossRefPubMed
9.
go back to reference Poulin PA, Romanow HC, Rahbari N, Small R, Smyth CE, Hatchard T et al (2016) The relationship between mindfulness, pain intensity, pain catastrophizing, depression, and quality of life among cancer survivors living with chronic neuropathic pain. Support Care Cancer 24:4167–4175CrossRefPubMed Poulin PA, Romanow HC, Rahbari N, Small R, Smyth CE, Hatchard T et al (2016) The relationship between mindfulness, pain intensity, pain catastrophizing, depression, and quality of life among cancer survivors living with chronic neuropathic pain. Support Care Cancer 24:4167–4175CrossRefPubMed
10.
go back to reference van Son J, Nyklíček I, Nefs G, Speight J, Pop VJ, Pouwer F (2015) The association between mindfulness and emotional distress in adults with diabetes: could mindfulness serve as a buffer? Results from Diabetes MILES: the Netherlands. J Behav Med 38:251–260CrossRefPubMed van Son J, Nyklíček I, Nefs G, Speight J, Pop VJ, Pouwer F (2015) The association between mindfulness and emotional distress in adults with diabetes: could mindfulness serve as a buffer? Results from Diabetes MILES: the Netherlands. J Behav Med 38:251–260CrossRefPubMed
11.
go back to reference Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L (2006) Using self-report assessment methods to explore facets of mindfulness. Assessment 13:27–45CrossRef Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L (2006) Using self-report assessment methods to explore facets of mindfulness. Assessment 13:27–45CrossRef
12.
go back to reference Marikar Bawa FL, Mercer SW, Atherton RJ, Clague F, Keen A, Scott NW et al (2015) Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. Br J Gen Pract 65:e387–e400CrossRef Marikar Bawa FL, Mercer SW, Atherton RJ, Clague F, Keen A, Scott NW et al (2015) Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. Br J Gen Pract 65:e387–e400CrossRef
13.
go back to reference Curtis K, Osadchuk A, Katz J (2011) An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. J Pain Res 4:189–201CrossRefPubMedPubMedCentral Curtis K, Osadchuk A, Katz J (2011) An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. J Pain Res 4:189–201CrossRefPubMedPubMedCentral
14.
15.
go back to reference Jones KD, Mist SD, Casselberry MA, Ali A, Christopher MS (2015) Fibromyalgia impact and mindfulness characteristics in 4986 people with fibromyalgia. Explor J Sci Health 11:304–309 Jones KD, Mist SD, Casselberry MA, Ali A, Christopher MS (2015) Fibromyalgia impact and mindfulness characteristics in 4986 people with fibromyalgia. Explor J Sci Health 11:304–309
16.
go back to reference Kraemer KM, McLeish AC, Johnson AL (2015) Associations between mindfulness and panic symptoms among young adults with asthma. Psychol Health Med 20:322–331CrossRefPubMed Kraemer KM, McLeish AC, Johnson AL (2015) Associations between mindfulness and panic symptoms among young adults with asthma. Psychol Health Med 20:322–331CrossRefPubMed
17.
go back to reference Veehof MM, Oskam MJ, Schreurs KMG, Bohlmeijer ET (2011) Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain 152:533–542CrossRefPubMed Veehof MM, Oskam MJ, Schreurs KMG, Bohlmeijer ET (2011) Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain 152:533–542CrossRefPubMed
18.
go back to reference Wang C, McAlindon T, Fielding RA, Harvey WF, Driban JB, Price LL et al (2015) A novel comparative effectiveness study of Tai Chi versus aerobic exercise for fibromyalgia: study protocol for a randomized controlled trial. Trials 16:34CrossRefPubMedPubMedCentral Wang C, McAlindon T, Fielding RA, Harvey WF, Driban JB, Price LL et al (2015) A novel comparative effectiveness study of Tai Chi versus aerobic exercise for fibromyalgia: study protocol for a randomized controlled trial. Trials 16:34CrossRefPubMedPubMedCentral
19.
go back to reference Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al (1990) The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172CrossRefPubMed Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL et al (1990) The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172CrossRefPubMed
20.
go back to reference Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P et al (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62:600–610CrossRef Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P et al (2010) The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res 62:600–610CrossRef
21.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed Folstein MF, Folstein SE, McHugh PR (1975) ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRefPubMed
22.
go back to reference Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL (2009) The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther 11:R120CrossRefPubMedPubMedCentral Bennett RM, Friend R, Jones KD, Ward R, Han BK, Ross RL (2009) The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther 11:R120CrossRefPubMedPubMedCentral
23.
go back to reference Amtmann D, Cook KF, Jensen MP, Chen WH, Choi S, Revicki D et al (2010) Development of a PROMIS item bank to measure pain interference. Pain 150:173–182CrossRefPubMedPubMedCentral Amtmann D, Cook KF, Jensen MP, Chen WH, Choi S, Revicki D et al (2010) Development of a PROMIS item bank to measure pain interference. Pain 150:173–182CrossRefPubMedPubMedCentral
25.
go back to reference Anderson J, Caplan L, Yazdany J, Robbins ML, Neogi T, Michaud K et al (2012) Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice. Arthritis Care Res (Hoboken) 64:640–647CrossRef Anderson J, Caplan L, Yazdany J, Robbins ML, Neogi T, Michaud K et al (2012) Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice. Arthritis Care Res (Hoboken) 64:640–647CrossRef
26.
go back to reference Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: Visual Analog Scale for pain (VAS pain), Numeric Rating Scale for pain (NRS pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF). Arthritis Care Res 63. https://doi.org/10.1002/acr.20543 Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: Visual Analog Scale for pain (VAS pain), Numeric Rating Scale for pain (NRS pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF). Arthritis Care Res 63. https://​doi.​org/​10.​1002/​acr.​20543
27.
go back to reference Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385CrossRef Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385CrossRef
28.
go back to reference Härter M, Reuter K, Gross-Hardt K, Bengel J (2001) Screening for anxiety, depressive and somatoform disorders in rehabilitation--validity of HADS and GHQ-12 in patients with musculoskeletal disease. Disabil Rehabil 23:737–744CrossRefPubMed Härter M, Reuter K, Gross-Hardt K, Bengel J (2001) Screening for anxiety, depressive and somatoform disorders in rehabilitation--validity of HADS and GHQ-12 in patients with musculoskeletal disease. Disabil Rehabil 23:737–744CrossRefPubMed
29.
go back to reference Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370CrossRef Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370CrossRef
30.
go back to reference Burckhardt CS, Henriksson C (2001) The coping strategies questionnaire–Swedish version: evidence of reliability and validity in patients with fibromyalgia. Scand J Behav Ther 30:97–107CrossRef Burckhardt CS, Henriksson C (2001) The coping strategies questionnaire–Swedish version: evidence of reliability and validity in patients with fibromyalgia. Scand J Behav Ther 30:97–107CrossRef
31.
go back to reference Rosenstiel AK, Keefe FJ (1983) The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 17:33–44CrossRefPubMed Rosenstiel AK, Keefe FJ (1983) The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain 17:33–44CrossRefPubMed
32.
go back to reference McHorney CA, Ware JE, Rachel Lu JF, Sherbourne CD (1994) The MOS 36-ltem Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32:40–66CrossRef McHorney CA, Ware JE, Rachel Lu JF, Sherbourne CD (1994) The MOS 36-ltem Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 32:40–66CrossRef
33.
go back to reference Jenkinson C, Wright L, Coulter A (1994) Criterion validity and reliability of the SF-36 in a population sample. Qual Life Res 3:7–12CrossRef Jenkinson C, Wright L, Coulter A (1994) Criterion validity and reliability of the SF-36 in a population sample. Qual Life Res 3:7–12CrossRef
35.
go back to reference Lorig K, Chastain RL, Ung E, Shoor S, Holman HR (1989) Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 32:37–44CrossRefPubMed Lorig K, Chastain RL, Ung E, Shoor S, Holman HR (1989) Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 32:37–44CrossRefPubMed
36.
go back to reference Harada ND, Chiu V, Stewart AL (1999) Mobility-related function in older adults: assessment with a 6-minute walk test. Arch Phys Med Rehabil 80:837–841CrossRefPubMed Harada ND, Chiu V, Stewart AL (1999) Mobility-related function in older adults: assessment with a 6-minute walk test. Arch Phys Med Rehabil 80:837–841CrossRefPubMed
37.
go back to reference Interaction [computer program]. Version 1.17. Fullerton, CA: Soper D; 2013 Interaction [computer program]. Version 1.17. Fullerton, CA: Soper D; 2013
38.
go back to reference Bergomi C, Ströhle G, Michalak J, Funke F, Berking M (2013) Facing the dreaded: does mindfulness facilitate coping with distressing experiences? A moderator analysis. Cogn Behav Ther 42:21–30CrossRefPubMed Bergomi C, Ströhle G, Michalak J, Funke F, Berking M (2013) Facing the dreaded: does mindfulness facilitate coping with distressing experiences? A moderator analysis. Cogn Behav Ther 42:21–30CrossRefPubMed
39.
go back to reference Christopher MS, Neuser NJ, Michael PG, Baitmangalkar A (2012) Exploring the psychometric properties of the five facet mindfulness questionnaire. Mindfulness (N Y) 3:124–131CrossRef Christopher MS, Neuser NJ, Michael PG, Baitmangalkar A (2012) Exploring the psychometric properties of the five facet mindfulness questionnaire. Mindfulness (N Y) 3:124–131CrossRef
41.
go back to reference Cash E, Salmon P, Weissbecker I, Rebholz WN, Bayley-Veloso R, Zimmaro LA et al (2015) Mindfulness meditation alleviates fibromyalgia symptoms in women: results of a randomized clinical trial. Ann Behav Med 49:319–330CrossRefPubMedPubMedCentral Cash E, Salmon P, Weissbecker I, Rebholz WN, Bayley-Veloso R, Zimmaro LA et al (2015) Mindfulness meditation alleviates fibromyalgia symptoms in women: results of a randomized clinical trial. Ann Behav Med 49:319–330CrossRefPubMedPubMedCentral
42.
go back to reference Malin K, Littlejohn GO (2016) Psychological factors mediate key symptoms of fibromyalgia through their influence on stress. Clin Rheumatol 35:2353–2357CrossRefPubMed Malin K, Littlejohn GO (2016) Psychological factors mediate key symptoms of fibromyalgia through their influence on stress. Clin Rheumatol 35:2353–2357CrossRefPubMed
43.
go back to reference de Bruin EI, Topper M, Muskens JGAM, Bögels SM, Kamphuis JH (2012) Psychometric properties of the five facets mindfulness questionnaire (FFMQ) in a meditating and a non-meditating sample. Assessment 19:187–197CrossRefPubMed de Bruin EI, Topper M, Muskens JGAM, Bögels SM, Kamphuis JH (2012) Psychometric properties of the five facets mindfulness questionnaire (FFMQ) in a meditating and a non-meditating sample. Assessment 19:187–197CrossRefPubMed
44.
go back to reference Davis MC, Zautra AJ (2013) An online mindfulness intervention targeting socioemotional regulation in fibromyalgia: results of a randomized controlled trial. Ann Behav Med 46:273–284CrossRefPubMed Davis MC, Zautra AJ (2013) An online mindfulness intervention targeting socioemotional regulation in fibromyalgia: results of a randomized controlled trial. Ann Behav Med 46:273–284CrossRefPubMed
45.
go back to reference Goldberg SB, Wielgosz J, Dahl C, Schuyler B, MacCoon DS, Rosenkranz M, Lutz A, Sebranek CA, Davidson RJ (2015) Does the five facet mindfulness questionnaire measure what we think it does? Construct validity evidence from an active controlled randomized clinical trial. Psychol Assess 28(8):1009–1014CrossRefPubMedPubMedCentral Goldberg SB, Wielgosz J, Dahl C, Schuyler B, MacCoon DS, Rosenkranz M, Lutz A, Sebranek CA, Davidson RJ (2015) Does the five facet mindfulness questionnaire measure what we think it does? Construct validity evidence from an active controlled randomized clinical trial. Psychol Assess 28(8):1009–1014CrossRefPubMedPubMedCentral
Metadata
Title
Mindfulness is associated with psychological health and moderates the impact of fibromyalgia
Authors
Brandon Pleman
Michelle Park
Xingyi Han
Lori Lyn Price
Raveendhara R. Bannuru
William F. Harvey
Jeffrey B. Driban
Chenchen Wang
Publication date
01-06-2019
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 6/2019
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-019-04436-1

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