title: Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression.
abstract: Body awareness has been proposed as one of the major mechanisms of mindfulness interventions, and it has been shown that chronic pain and depression are associated with decreased levels of body awareness. We investigated the effect of Mindfulness-Based Cognitive Therapy (MBCT) on body awareness in patients with chronic pain and comorbid active depression compared to treatment as usual (TAU; N = 31). Body awareness was measured by a subset of the Multidimensional Assessment of Interoceptive Awareness (MAIA) scales deemed most relevant for the population. These included: Noticing, Not-Distracting, Attention Regulation, Emotional Awareness, and Self-Regulation. In addition, pain catastrophizing was measured by the Pain Catastrophizing Scale (PCS). These scales had adequate to high internal consistency in the current sample. Depression severity was measured by the Quick Inventory of Depressive Symptomatology-Clinician rated (QIDS-C16). Increases in the MBCT group were significantly greater than in the TAU group on the "Self-Regulation" and "Not Distracting" scales. Furthermore, the positive effect of MBCT on depression severity was mediated by "Not Distracting." These findings provide preliminary evidence that a mindfulness-based intervention may increase facets of body awareness as assessed with the MAIA in a population of pain patients with depression. Furthermore, they are consistent with a long hypothesized mechanism for mindfulness and emphasize the clinical relevance of body awareness.
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA; Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical CenterMaastricht, Netherlands; MondriaanMaastricht, Netherlands.
authors.forename: Marasha
authors.initials: M
authors.lastname: de Jong
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA.
authors.forename: Sara W
authors.initials: SW
authors.lastname: Lazar
authors.affiliation: Department of Psychosomatic Medicine, Medical Faculty, Medical Center-University of FreiburgFreiburg, Germany; Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of BaselBasel, Switzerland.
authors.forename: Kiran
authors.initials: K
authors.lastname: Hug
authors.affiliation: Department of Family and Community Medicine, Osher Center for Integrative Medicine, University of California, San Francisco San Francisco, CA, USA.
authors.forename: Wolf E
authors.initials: WE
authors.lastname: Mehling
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA; Department of Neuroradiology, Klinikum rechts der Isar, Technical University of MunichMunich, Germany.
authors.forename: Britta K
authors.initials: BK
authors.lastname: Hölzel
authors.affiliation: Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University Maastricht, Netherlands.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Sack
authors.affiliation: Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center Maastricht, Netherlands.
authors.forename: Frenk
authors.initials: F
authors.lastname: Peeters
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Ashih
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School Boston, MA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Mischoulon
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, USA; Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of ZurichZurich, Switzerland; Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and Swiss Federal Institute of Technology (ETH)Zurich, Switzerland.
authors.forename: Tim
authors.initials: T
authors.lastname: Gard
keywords: body awareness; chronic pain; depression; interoceptive awareness; mediation; mindfulness meditation; mindfulness-based cognitive therapy; pain catastrophizing