Mindfulness-based behavioral activation interventions may protect from the negative effects of stress and depression among people with fibromyalgia, a study reports.
The research, published in the Journal of Mental Health, was based on the idea that stressful life events, such as the development of chronic pain in fibromyalgia, triggers depression through its impact on daily living activities.
The interference with daily activities causes a downward spiral with unsatisfying experiences and negative self-appraisal, which set the context for depressive episodes.
Mindfulness is defined as the process of bringing one’s attention to what is happening in the present moment. As mindfulness practice has been shown to protect against the negative effects of psychological stress, researchers at Dartmouth College in New Hampshire, and their colleagues at the University of Wisconsin-Madison, figured that interventions employing mindfulness methods may be effective in limiting the impact of depression in fibromyalgia.
To explore this premise, in the study “Mindfulness as a protective factor against depressive symptoms in people with fibromyalgia,” the team surveyed 117 patients with fibromyalgia using a range of validated tools measuring pain, stress, depression, and related factors.
Based on data from this group of patients, the team built a statistical model to explore the relationships between these factors.
Mindful behavior was measured using the Cognitive and Affective Mindfulness Scale-Revised — a tool that assesses everyday mindfulness practice with regard to thoughts and feelings.
Analyses showed that depression was linked to disability, perceived stress, pain catastrophizing, overall patient health, as well as to the level of mindful behavior. Mindfulness, in turn, also was linked to stress, activity interference, catastrophizing and depression.
To better understand all these links, the team performed an advanced statistical analysis, which showed that the link between depression or mindfulness and pain intensity was not valid.
This type of analysis allowed researchers to get an indication of the order of relationships.
Data suggested that mindfulness was protective against perceived stress, which impacted activity interference and pain catastrophizing. These factors, in turn, were linked to depression.
Mindfulness was not related to pain intensity in this study. Pain intensity, however, negatively impacted perceived stress, activity interference and catastrophizing.
Pain intensity also was not directly related to depressive symptoms; rather, it appeared to affect depression through its impact on stress, activity interference and catastrophizing.
These results add to evidence that pain is a primary symptom of fibromyalgia, researchers said.
Nevertheless, stress and depression adds to the disease burden of fibromyalgia patients, and makes pain management more difficult. Therefore, researchers suggest that mindfulness-based interventions may be valuable in reducing disease impact in these patients.
“Mindfulness seems to play an important role as a protective factor against the negative effects of stress and depression among people with FM [fibromyalgia] and should be included in mental health interventions for chronic pain.” the team concluded.