title: Mindfulness and cognitive-behavioral interventions for chronic pain: differential effects on daily pain reactivity and stress reactivity.
abstract: OBJECTIVE
  This study compared the impact of cognitive-behavioral therapy for pain (CBT-P), mindful awareness and acceptance treatment (M), and arthritis education (E) on day-to-day pain- and stress-related changes in cognitions, symptoms, and affect among adults with rheumatoid arthritis (RA).
  
  
  METHODS
  One hundred forty-three RA patients were randomized to 1 of the 3 treatment conditions. CBT-P targeted pain-coping skills; M targeted awareness and acceptance of current experience to enhance coping with a range of aversive experiences; E provided information regarding RA pain and its management. At pre- and posttreatment, participants completed 30 consecutive evening diaries assessing that day's pain, fatigue, pain-related catastrophizing and perceived control, morning disability, and serene and anxious affects.
  
  
  RESULTS
  Multilevel models compared groups in the magnitude of within-person change in daily pain and stress reactivity from pre- to posttreatment. M yielded greater reductions than did CBT-P and E in daily pain-related catastrophizing, morning disability, and fatigue and greater reductions in daily stress-related anxious affect. CBT-P yielded less pronounced declines in daily pain-related perceived control than did M and E.
  
  
  CONCLUSIONS
  For individuals with RA, M produces the broadest improvements in daily pain and stress reactivity relative to CBT-P and E. These findings also highlight the utility of a diary-based approach to evaluating the treatment-related changes in responses to daily life.
authors.affiliation: Department of Psychology.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Davis
authors.affiliation: Department of Psychology.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Zautra
authors.affiliation: Department of Psychology.
authors.forename: Laurie D
authors.initials: LD
authors.lastname: Wolf
authors.affiliation: Department of Community Medicine and Health Care, University of Connecticut Health Center.
authors.forename: Howard
authors.initials: H
authors.lastname: Tennen
authors.affiliation: Department of Psychology.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Yeung
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D058443:Catastrophization / Q000628:therapy; D059350:Chronic Pain / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult