Biological mechanisms related to the effectiveness of guided imagery for chronic pain.
Specific aims of this pilot study were to (a) determine the effect of a guided imagery (GI) intervention over an 8-week period on pain and pain disability in a sample of persons with chronic noncancer pain (CNCP) and (b) analyze the mediating effects of neuroendocrine and neuroimmune functioning on the effectiveness of GI on outcome variables. A simple interrupted time-series design (12-week period) was used. GI was introduced at Week 4 and used daily by 25 participants for the remaining 8 weeks. Measures of pain and pain disability were obtained at the beginning of the study period and at six repeated 2-week intervals. Measures of hypothalamic-pituitary-adrenal (HPA) axis activation (plasma cortisol), immune-mediated analgesia (lymphocyte subset counts and proliferation), and immune-mediated hyperalgesia (interleukin-1β) were obtained at the beginning of the study and at Week 11. Usual pain levels were lower after the introduction of GI at Week 4 (Wilks' λ = 52.31; df = 2, 22; p = .000). Pain disability levels were lower after the introduction of GI at Week 4 (Wilks' λ = 5.98; df = 6, 18; p = .001). Correlation coefficients between change scores of dependent variables and mediating variables were not significant. GI was effective in reducing pain intensity and pain disability over an 8-week period; however, the results did not support the expected effects of decreased HPA axis activation, improved immune-mediated analgesia, and reduced immune-mediated hyperalgesia in mediating these outcomes. These findings may be related to procedural and theoretical issues and limitations related to the study design.
College of Nursing, Kent State University, Kent, OH 44242, USA. wlewando@kent.edu
Wendy
W
Lewandowski
Ann
A
Jacobson
Patrick A
PA
Palmieri
Thomas
T
Alexander
Richard
R
Zeller
D002908:Chronic Disease; D006801:Humans; D007030:Hypothalamo-Hypophyseal System; D019018:Imagery, Psychotherapy; D010146:Pain / Q000523:psychology*; D010913:Pituitary-Adrenal System; D013315:Stress, Psychological