Table 2.
Treatment effects of Mindfulness-Oriented Recovery Enhancement (MORE) versus Supportive Psychotherapy (Support) on primary/secondary outcomes and process variables.
| Pre-Treatment | 2 months | 4 months | 6 months | 8 months | Between-groups treatment effect (SE) [95% CI], p-value | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||||||
| Mean | SE | N | Mean | SE | N | Mean | SE | N | Mean | SE | N | Mean | SE | N | ||
| Pain Interference-BPI | ||||||||||||||||
| MORE | 6.04 | 0.30 | 116 | 5.10 | 0.21 | 92 | 5.37 | 0.22 | 84 | 5.44 | 0.22 | 81 | 5.33 | 0.22 | 79 | −0.47 (0.19) [−0.84, −0.10] |
| SG | 5.93 | 0.32 | 114 | 5.71 | 0.22 | 87 | 5.76 | 0.22 | 80 | 5.71 | 0.23 | 80 | 5.93 | 0.23 | 73 | p=.011 |
| Pain Severity-BPI | ||||||||||||||||
| MORE | 5.58 | 0.20 | 116 | 5.14 | 0.16 | 92 | 5.37 | 0.16 | 84 | 5.43 | 0.16 | 81 | 5.31 | 0.16 | 79 | −0.27 (0.14) [−0.54, 0.00] |
| SG | 5.59 | 0.22 | 114 | 5.48 | 0.16 | 87 | 5.58 | 0.16 | 80 | 5.53 | 0.16 | 80 | 5.76 | 0.17 | 73 | p=.048 |
| Aberrant Drug-Related Behaviors-COMM | ||||||||||||||||
| MORE | 10.46 | 1.04 | 116 | 10.84 | 0.63 | 92 | 9.61 | 0.65 | 84 | 9.48 | 0.65 | 81 | 8.89 | 0.66 | 79 | −0.46 (0.59) [−1.62, 0.69] |
| SG | 12.23 | 0.97 | 114 | 10.42 | 0.66 | 87 | 10.52 | 0.66 | 80 | 9.84 | 0.67 | 80 | 9.87 | 0.69 | 73 | p=.430 |
| Opioid Dose (sqrt) a | ||||||||||||||||
| MORE | 7.74 | 0.90 | 116 | 7.25 | 0.49 | 102 | 6.93 | 0.50 | 100 | 6.91 | 0.50 | 84 | 6.84 | 0.50 | 95 | −0.65 (0.30) [−1.23, −0.07] |
| SG | 8.00 | 0.94 | 114 | 7.75 | 0.50 | 105 | 7.85 | 0.50 | 93 | 7.64 | 0.50 | 98 | 7.29 | 0.51 | 92 | p=.029 |
| Emotional Distress-DASS | ||||||||||||||||
| MORE | 20.60 | 1.88 | 115 | 17.81 | 1.13 | 85 | 17.38 | 1.15 | 81 | 15.79 | 1.15 | 78 | 16.77 | 1.16 | 76 | −1.56 (0.95) [−3.42, 0.31) |
| SG | 17.52 | 1.93 | 108 | 18.89 | 1.18 | 80 | 19.13 | 1.17 | 80 | 17.41 | 1.21 | 72 | 17.88 | 1.46 | 70 | p.102 |
| Post-Traumatic Stress Symptoms-PCL | ||||||||||||||||
| MORE | 45.51 | 2.23 | 114 | 42.52 | 1.31 | 85 | 40.87 | 1.65 | 81 | 40.70 | 1.69 | 78 | 40.81 | 1.69 | 76 | −1.43 (1.06) [−3.51, 0.64] |
| SG | 41.80 | 2.22 | 108 | 42.52 | 1.35 | 80 | 43.38 | 1.36 | 79 | 41.54 | 1.38 | 72 | 41.57 | 1.38 | 70 | p.175 |
| Positive Affect-PANAS | ||||||||||||||||
| MORE | 28.54 | 1.07 | 115 | 33.15 | 0.74 | 85 | 32.11 | 0.75 | 81 | 31.95 | 0.76 | 77 | 32.11 | 0.76 | 76 | 1.50 (0.69) [0.15, 2.85] |
| SG | 34.22 | 1.22 | 108 | 36.81 | 0.78 | 79 | 36.37 | 0.77 | 80 | 34.47 | 0.80 | 71 | 36.19 | 0.80 | 69 | p=029 |
| Anhedonia-SHAPS | ||||||||||||||||
| MORE | 25.78 | 0.96 | 115 | 23.19 | 0.65 | 85 | 23.63 | 0.66 | 81 | 25.53 | 0.66 | 78 | 23.81 | 0.67 | 76 | −2.27 (0.59) [−3.42, −1.11] |
| SG | 26.87 | 0.95 | 108 | 24.85 | 0.68 | 79 | 25.30 | 0.68 | 80 | 26.57 | 0.71 | 72 | 26.51 | 0.70 | 71 | p<.001 |
| Attention to Positive Information-APNIS | ||||||||||||||||
| MORE | 40.53 | 0.91 | 115 | 43.26 | 0.59 | 85 | 43.06 | 0.60 | 80 | 43.28 | 0.60 | 78 | 43.49 | 0.60 | 76 | 1.72 (0.53) [−0.69, 2.76] |
| SG | 41.97 | 0.95 | 108 | 41.41 | 0.62 | 80 | 41.99 | 0.61 | 80 | 41.31 | 0.63 | 72 | 41.48 | 0.63 | 70 | p=.001 |
| Mindful Reappraisal of Pain Sensations-MRPS | ||||||||||||||||
| MORE | 13.87 | 1.44 | 115 | 22.36 | 1.04 | 85 | 21.58 | 1.06 | 81 | 20.57 | 1.06 | 78 | 19.84 | 1.12 | 76 | 6.38 (0.98) [4.46, 8.31] |
| SG | 12.43 | 1.38 | 108 | 15.02 | 1.09 | 80 | 14.82 | 1.08 | 80 | 16.00 | 1.12 | 73 | 15.70 | 1.12 | 71 | p<.001 |
| Nonreactivity to Distressing Thoughts and Emotions-FFMQ | ||||||||||||||||
| MORE | 22.31 | 0.63 | 115 | 22.79 | 0.48 | 85 | 23.45 | 0.49 | 81 | 23.18 | 0.49 | 79 | 23.81 | 0.49 | 76 | 0.95 (0.44) [0.09, 1.81] |
| SG | 23.41 | 0.78 | 109 | 22.72 | 0.48 | 81 | 22.47 | 0.50 | 79 | 22.55 | 0.52 | 73 | 21.98 | 0.51 | 71 | p=.030 |
| Pain Catastrophizing-CSQ | ||||||||||||||||
| MORE | 13.75 | 1.18 | 115 | 10.32 | 0.75 | 85 | 9.16 | 0.76 | 81 | 9.40 | 0.76 | 78 | 8.91 | 0.77 | 76 | −2.54 (0.69) [−3.98, −1.19] |
| SG | 12.43 | 1.22 | 108 | 11.98 | 0.78 | 79 | 11.96 | 0.78 | 80 | 11.70 | 0.80 | 73 | 12.31 | 0.80 | 71 | p<.001 |
MORE = Mindfulness-Oriented Recovery Enhancement. SG = Supportive Group Psychotherapy. Post-treatment data are maximum likelihood estimates at each time point based on the longitudinal statistical model. Pre-treatment data are descriptive sample means. The between-groups treatment effect represents the main treatment effect (MORE - SG) estimated from the constrained longitudinal data analytic (cLDA) model in the original, unstandardized response variable metric.
Opioid dose was skewed and square-root transformed (sqrt) prior to analysis.
Note - means of nonlinearly transformed variables do not yield raw means under inverse transformation.
BPI = Brief Pain Inventory, range 0–10, score >4 indicates moderate pain; COMM = Current Opioid Misuse Measure, range 0–68, score >8 indicates misuse; DASS = Depression Anxiety Stress Scale, range 0–63, score >20 indicates at least moderate levels of distress; PCL = Posttraumatic Symptom Checklist-Military Version, range 18–90, score >44 indicates a likely PTSD diagnosis; PANAS = Positive and Negative Affect Schedule-Short Form, positive affect subscale range 10–50, score >31.3 exceeds the mean in healthy samples; SHAPS = Snaith Hamilton Anhedonia and Pleasure Scale, range 14–56, score >23 indicates anhedonia in people with chronic pain; APNIS = Attention to Positive and Negative Information Scale, attention to positive information subscale range 11–55; MRPS = Mindful Reappraisal of Pain Sensations Scale, range 0–54; FFMQ = Five Facet Mindfulness Questionnaire, nonreactivity subscale range 7–35; CSQ = Coping Strategies Questionnaire, pain catastrophizing subscale range 0–36, score >10.3 exceeds the mean in chronic pain samples.