Table 3:
Pain bothersomeness: Adjusted mean change and treatment effects at 8 weeks for subgroups defined by baseline characteristics.
| Adjusted mean change at 8 weeks | Treatment effect* | |||||
|---|---|---|---|---|---|---|
| UC | CBT | MBSR | CBT-UC | MBSR-UC | CBT-MBSR | |
| Baseline characteristic | Mean (95% CI) | Mean (95% CI) | Mean (95% CI) |
P-value† Mean (95% CI) |
P-value† Mean (95% CI) |
P-value† Mean (95% CI) |
| Overall | −0.57 (−0.92, −0.22) | −1.15 (−1.51, −0.80) | −1.26 (−1.63, −0.90) | −0.58 (−1.09, −0.08) | −0.69 (−1.20, −0.19) | 0.11 (−0.40, 0.62) |
| Age at baseline | 0.58 | 0.78 | 0.77 | |||
| <60 yrs | −0.58 (−0.97, −0.19) | −1.25 (−1.67, −0.82) | −1.31 (−1.74, −0.87) | −0.67 (−1.25, −0.09) | −0.73 (−1.32, −0.13) | 0.06 (−0.55, 0.67) |
| ≥60 yrs | −0.58 (−1.30, 0.15) | −0.92 (−1.59, −0.24) | −1.14 (−1.81, −0.47) | −0.34 (−1.33, 0.65) | −0.57 (−1.55, 0.42) | 0.22 (−0.73, 1.17) |
| Gender | 0.71 | 0.02 | 0.03 | |||
| Male | −1.15 (−1.86, −0.43) | −1.51 (−2.07, −0.96) | −0.93 (−1.52, −0.35) | −0.37 (−1.27, 0.53) | 0.21 (−0.71, 1.13) | −0.58 (−1.38, 0.22) |
| Female | −0.36 (−0.75, 0.02) | −0.93 (−1.40, −0.47) | −1.50 (−1.96, −1.03) | −0.57 (−1.17, 0.03) | −1.13 (−1.74, −0.53) | 0.56 (−0.09, 1.22) |
| Education | 0.62 | 0.31 | 0.62 | |||
| Less than bachelor’s degree | −0.14 (−0.72, 0.43) | −0.90 (−1.50, −0.29) | −1.15 (−1.69, −0.61) | −0.75 (−1.59, 0.08) | −1.01 (−1.79, −0.22) | 0.25 (−0.55, 1.06) |
| Bachelor’s degree | −0.83 (−1.26, −0.40) | −1.32 (−1.76, −0.87) | −1.31 (−1.81, −0.81) | −0.49 (−1.11, 0.13) | −0.48 (−1.14, 0.18) | −0.01 (−0.68, 0.65) |
| Functional limitations | 0.64 | 0.98 | 0.66 | |||
| mRDQ <14 | −0.64 (−1.06, −0.23) | −1.16 (−1.61, −0.70) | −1.34 (−1.79, −0.89) | −0.51 (−1.12, 0.10) | −0.7 (−1.31, −0.09) | 0.19 (−0.45, 0.82) |
| mRDQ ≥14 | −0.39 (−1.05, 0.28) | −1.16 (−1.78, −0.53) | −1.10 (−1.75, −0.45) | −0.77 (−1.66, 0.12) | −0.72 (−1.63, 0.20) | −0.06 (−0.94, 0.83) |
| Pain bothersomeness | 0.85 | 0.91 | 0.94 | |||
| <7 | −0.02 (−0.46, 0.43) | −0.70 (−1.14, −0.25) | −0.73 (−1.19, −0.26) | −0.68 (−1.31, −0.05) | −0.71 (−1.36, −0.06) | 0.03 (−0.61, 0.67) |
| ≥7 | −1.61 (−2.20, −1.03) | −2.19 (−2.86, −1.52) | −2.27 (−2.92, −1.61) | −0.57 (−1.46, 0.31) | −0.65 (−1.53, 0.22) | 0.08 (−0.86, 1.01) |
| Depressive symptoms | 0.18 | 0.52 | 0.48 | |||
| PHQ-8 <10 | −0.62 (−1.00, −0.25) | −1.05 (−1.45, −0.66) | −1.25 (−1.66, −0.85) | −0.43 (−0.98, 0.12) | −0.63 (−1.18, −0.08) | 0.20 (−0.36, 0.76) |
| PHQ ≥10 | −0.22 (−1.17, 0.73) | −1.60 (−2.43, −0.77) | −1.31 (−2.21, −0.42) | −1.38 (−2.65, −0.11) | −1.09 (−2.39, 0.20) | −0.29 (−1.52, 0.94) |
| Depressive symptoms | 0.69 | 0.004 | 0.01 | |||
| PHQ-8 <5 | −0.31 (−0.79, 0.17) | −0.99 (−1.51, −0.46) | −1.76 (−2.28, −1.24) | −0.67 (−1.38, 0.03) | −1.45 (−2.16, −0.73) | 0.77 (0.03, 1.51) |
| PHQ-8 ≥5 | −0.83 (−1.32, −0.34) | −1.30 (−1.79, −0.82) | −0.81 (−1.31, −0.31) | −0.47 (−1.16, 0.22) | 0.02 (−0.68, 0.72) | −0.49 (−1.19, 0.20) |
| Expected pain improvement | 0.76 | 0.31 | 0.20 | |||
| 1–2 (pain gone or much better) | −1.18 (−1.81, −0.54) | −1.90 (−2.58, −1.21) | −1.47 (−2.10, −0.84) | −0.72 (−1.65, 0.21) | −0.29 (−1.19, 0.61) | −0.43 (−1.35, 0.50) |
| 3–7 (pain worse, unchanged, or somewhat better) | −0.33 (−0.74, 0.07) | −0.88 (−1.30, −0.46) | −1.18 (−1.63, −0.74) | −0.55 (−1.14, 0.04) | −0.85 (−1.45, −0.25) | 0.30 (−0.31, 0.91) |
| Expected program helpfulness | 0.37 | 0.95 | 0.36 | |||
| <8 | −0.63 (−1.17, −0.10) | −0.99 (−1.49, −0.50) | −1.35 (−1.91, −0.78) | −0.36 (−1.09, 0.37) | −0.71 (−1.49, 0.06) | 0.35 (−0.39, 1.10) |
| ≥8 | −0.52 (−0.98, −0.06) | −1.34 (−1.86, 0.82) | −1.20 (−1.69, −0.72) | −0.82 (−1.51, −0.12) | −0.68 (−1.35, −0.01) | −0.13 (−0.85, 0.58) |
| Widespread pain | 0.80 | 0.60 | 0.44 | |||
| <4 | −0.64 (−1.25, −0.04) | −1.15 (−1.72, −0.58) | −1.50 (−2.07, −0.92) | −0.51 (−1.33, 0.32) | −0.85 (−1.69, −0.02) | 0.35 (−0.45, 1.15) |
| ≥4 | −0.53 (−0.95, −0.10) | −1.16 (−1.63, −0.70) | −1.10 (−1.58, −0.62) | −0.64 (−1.27, −0.01) | −0.57 (−1.21, 0.07) | −0.06 (−0.74, 0.61) |
| Anxiety | 0.54 | 0.99 | 0.54 | |||
| GAD-2 <3 | −0.54 (−0.91, −0.17) | −1.04 (−1.44, −0.65) | −1.22 (−1.63, −0.81) | −0.50 (−1.05, 0.04) | −0.68 (−1.24, −0.13) | 0.18 (−0.38, 0.75) |
| GAD-2 ≥3 | −0.76 (−1.65, 0.14) | −1.69 (−2.55, −0.82) | −1.44 (−2.31, −0.58) | −0.93 (−2.18, 0.32) | −0.69 (−1.92, 0.54) | −0.24 (−1.48, 1.00) |
| SOPA Disability | 0.16 | 0.22 | 0.86 | |||
| <2 | −0.45 (−0.88, −0.01) | −1.32 (−1.80, −0.85) | −1.40 (−1.89, −0.90) | −0.88 (−1.52, −0.23) | −0.95 (−1.61, −0.29) | 0.08 (−0.61, 0.76) |
| ≥2 | −0.79 (−1.36, −0.22) | −0.93 (−1.48, −0.39) | −1.10 (−1.64, −0.56) | −0.14 (−0.93, 0.65) | −0.31 (−1.10, 0.48) | 0.17 (−0.6, 0.94) |
| SOPA Harm | 0.02 | 0.30 | 0.18 | |||
| <2 | −0.39 (−0.90, 0.12) | −1.54 (−2.00, −1.07) | −1.36 (−1.86, −0.86) | −1.14 (−1.84, −0.45) | −0.97 (−1.69, −0.24) | −0.18 (−0.86, 0.50) |
| ≥2 | −0.72 (−1.19, −0.26) | −0.62 (−1.17, −0.06) | −1.15 (−1.69, −0.62) | 0.10 (−0.62, 0.83) | −0.43 (−1.14, 0.28) | 0.53 (−0.24, 1.30) |
| SOPA Control | 0.28 | 0.84 | 0.40 | |||
| <3 | −0.46 (−0.90, −0.02) | −0.83 (−1.28, −0.38) | −1.11 (−1.58, −0.63) | −0.37 (−1.00, 0.26) | −0.65 (−1.3, 0.00) |
0.28 (−0.38, 0.93) |
| ≥3 | −0.75 (−1.31, −0.20) | −1.68 (−2.26, −1.10) | −1.51 (−2.09, −0.92) | −0.93 (−1.72, −0.13) | −0.75 (−1.55, 0.04) | −0.17 (−0.99, 0.65) |
| SOPA Emotion | 0.83 | 0.54 | 0.69 | |||
| <3 | −0.53 (−0.97, −0.10) | −1.16 (−1.65, −0.68) | −1.36 (−1.86, −0.87) | −0.63 (−1.28, 0.02) | −0.83 (−1.49, −0.17) | 0.20 (−0.49, 0.89) |
| ≥3 | −0.62 (−1.19, −0.05) | −1.14 (−1.69, −0.60) | −1.13 (−1.69, −0.57) | −0.52 (−1.31, 0.26) | −0.51 (−1.31, 0.29) | −0.01 (−0.8, 0.77) |
| Pain catastrophizing | 0.75 | 0.79 | 0.57 | |||
| PCS <30 | −0.64 (−1.65, 0.36) | −1.01 (−2.01, 0.08) | −1.50 (−2.45, −0.54) | −0.37 (−1.82, 1.09) | −0.85 (−2.23, 0.52) | 0.49 (−0.95, 1.92) |
| PCS ≥30 | −0.56 (−0.93, −0.18) | −1.17 (−1.55, −0.78) | −1.21 (−1.61, −0.81) | −0.61 (−1.15, −0.08) | −0.66 (−1.2, −0.11) | 0.04 (−0.51, 0.60) |
| Pain acceptance | 0.11 | 0.08 | 0.09 | |||
| CPAQ-8 <32 | −0.84 (−1.32, −0.37) | −1.03 (−1.53, −0.53) | −1.09 (−1.61, −0.56) | −0.19 (−0.88, 0.50) | −0.24 (−0.96, 0.47) | 0.05 (−0.67, 0.78) |
| CPAQ-8 ≥32 | −0.28 (−0.78, 0.22) | −1.28 (−1.80, −0.77) | −1.43 (−1.94, −0.92) | −1.00 (−1.72, −0.29) | −1.15 (−1.86, −0.44) | 0.14 (−0.58, 0.87) |
| Pain self-efficacy | 0.11 | 0.03 | 0.59 | |||
| PSEQ <50 | −0.77 (−1.22, −0.33) | −1.00 (−1.50, −0.51) | −1.02 (−1.49, −0.55) | −0.23 (−0.9, 0.43) | −0.25 (−0.90, 0.40) | 0.02 (−0.66, 0.70) |
| PSEQ ≥50 | −0.28 (−0.82, 0.26) | −1.33 (−1.85, −0.80) | −1.63 (−2.21, −1.05) | −1.05 (−1.8, −0.30) |
−1.35 (−2.14, −0.56) | 0.30 (−0.48, 1.08) |
| FFMQ-SF OB | 0.51 | 0.28 | 0.10 | |||
| <4 | −0.65 (−1.14, −0.16) | −1.08 (−1.56, −0.60) | −1.54 (−2.01, −1.07) | −0.43 (−1.12, 0.26) | −0.89 (−1.57, −0.21) | 0.46 (−0.21, 1.13) |
| ≥4 | −0.49 (−0.97, −0.01) | −1.25 (−1.78, −0.72) | −0.82 (−1.42, −0.23) | −0.76 (−1.48, −0.04) | −0.33 (−1.10, 0.43) | −0.43 (−1.22, 0.37) |
| FFMQ-SF AA | 0.42 | 0.31 | 0.83 | |||
| <4 | −0.50 (−0.91, −0.09) | −1.22 (−1.67, −0.78) | −1.37 (−1.82, −0.92) | −0.72 (−1.33, −0.11) | −0.87 (−1.48, −0.26) | 0.15 (−0.49, 0.78) |
| ≥4 | −0.75 (−1.39, −0.11) | −1.02 (−1.64, −0.41) | −1.05 (−1.70, −0.41) | −0.28 (−1.16, 0.61) | −0.30 (−1.21, 0.60) | 0.03 (−0.85, 0.91) |
| FFMQ-SF NR | 0.21 | 0.68 | 0.38 | |||
| <4 | −0.67 (−1.06, −0.28) | −1.08 (−1.51, −0.64) | −1.34 (−1.79, −0.89) | −0.40 (−0.98, 0.18) | −0.67 (−1.26, −0.08) | 0.27 (−0.35, 0.89) |
| ≥4 | −0.19 (−0.94, 0.57) | −1.33 (−1.98, −0.67) | −1.10 (−1.75, −0.46) | −1.14 (−2.14, −0.14) | −0.92 (−1.92, 0.08) | −0.22 (−1.13, 0.69) |
| FFMQ-SF NJ | 0.40 | 0.21 | 0.04 | |||
| <4 | −0.48 (−0.98, 0.01) | −1.31 (−1.85, −0.78) | −0.86 (−1.38, −0.33) | −0.83 (−1.56, −0.10) | −0.37 (−1.09, 0.35) | −0.46 (−1.22, 0.30) |
| ≥4 | −0.64 (−1.11, −0.16) | −1.04 (−1.52, −0.56) | −1.65 (−2.16, −1.14) | −0.40 (−1.08, 0.28) | −1.01 (−1.71, −0.31) | 0.61 (−0.09, 1.31) |
| Opioid use, past wk | 0.74 | 0.09 | 0.18 | |||
| No | −0.48 (−0.85, −0.11) | −1.10 (−1.48, −0.72) | −1.33 (−1.71, −0.95) | −0.62 (−1.15, −0.09) | −0.85 (−1.39, −0.31) | 0.23 (−0.31, 0.77) |
| Yes | −1.25 (−2.29, −0.21) | −1.59 (−2.71, −0.48) | −0.56 (−1.89, 0.77) | −0.34 (−1.86, 1.18) | 0.69 (−0.99, 2.37) | −1.04 (−2.78, 0.71) |
AA, Acting with Awareness; CBT, cognitive-behavioral therapy; CI, confidence interval; CPAQ-8, Chronic Pain Acceptance Questionnaire-8; FFMQ-SF, Five Facet Mindfulness Questionnaire-short form; GAD, Generalized Anxiety Disorder; MBSR, Mindfulness-Based Stress Reduction; NJ, Nonjudging; NR, Nonreactivity; OB, Observing; PCS, Pain Catastrophizing Scale; PHQ, Patient Health Questionnaire; PSEQ, Pain Self-Efficacy Questionnaire; mRDQ, modified Roland Disability Questionnaire; SOPA, Survey of Pain Attitudes; UC, Usual Care
Models adjust for age, sex, education, pain duration, and baseline pain bothersomeness score
*
Treatment effect defined as the difference between the two treatment groups in the 8-week change on the outcome measure within a given subgroup. Treatment effect estimates are coded such that negative treatment effects favor CBT and MBSR in their comparisons with UC, and CBT in the comparison of CBT and MBSR
†
P-value for test of differences between subgroups in treatment effects at 8 weeks
Bold font indicates P < 0.05; only comparisons with P < 0.002 were statistically significant after Bonferroni adjustment for multiple comparisons.