Advertisement

Mindfulness

pp 1–8 | Cite as

Effect of Acceptance Versus Attention on Pain Tolerance: Dissecting Two Components of Mindfulness

  • Yuzheng Wang
  • Zhenzhen Qi
  • Stefan G. Hofmann
  • Mei Si
  • Xinghua LiuEmail author
  • Wei Xu
ORIGINAL PAPER

Abstract

Objectives

Previous studies have shown that brief mindfulness trainings can have significant analgesic effects. However, the effects of the various components of mindfulness on pain analgesia are not well understood. The objective of this study was to examine the effects of two components of mindfulness interventions—attention and acceptance—on pain analgesia.

Methods

One hundred and nineteen healthy college students without prior mindfulness experience underwent a cold-pressor test to measure pain tolerance before and after the training. Pain intensity, tolerance, distress, threshold, and endurance time were also tested. The participants were randomly assigned to one of the following four conditions: (1) acceptance of pain, (2) attention to pain, (3) acceptance of and attention to pain, or (4) control.

Results

The results showed that both the acceptance strategy and the combined acceptance and attention group increased pain endurance and tolerance after training. Furthermore, the acceptance group had longer pain endurance and tolerance times than the attention and control groups.

Conclusions

These results suggest that acceptance of pain is more important than attention to pain. Study limitations and future research directions are discussed.

Keywords

Mindfulness Acceptance Attention Pain Mechanism Short-term 

Notes

Acknowledgements

The authors thank Johann D’Souza for the proof-reading work.

Funding Sources

This research was supported by the National Science Foundation of China (Project 31271114). Dr. Hofmann receives financial support from the Alexander von Humboldt Foundation (as part of the Humboldt Prize), NIH/NCCIH (R01AT007257), NIH/NIMH (R01MH099021, U01MH108168), and the James S. McDonnell Foundation 21st Century Science Initiative in Understanding Human Cognition – Special Initiative. He receives compensation for his work as an advisor from the Palo Alto Health Sciences and for his work as a Subject Matter Expert from John Wiley & Sons, Inc. and SilverCloud Health, Inc. He also receives royalties and payments for his editorial work from various publishers.

Author Contributions

WY and LX conceived and designed the study, executed the study, analyzed the data, and wrote the paper. QZ collaborated with the collection of the data. SH, SM, and XW collaborated in the writing and editing of the final manuscript. All the authors approved the final version of the manuscript for submission.

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflict of interest.

Ethics Statement

The study received ethical approval from the Academic Committee of College of Psychology, Capital Normal University. No adverse events were reported in this study.

Informed Consent

Informed consent was obtained from all individual participants.

Supplementary material

12671_2019_1091_MOESM1_ESM.docx (20 kb)
ESM 1 (DOCX 19 kb)

References

  1. Baer, R. A. (2009). Self-focused attention and mechanisms of change in mindfulness-based treatment. Cognitive Behaviour Therapy, 38(Suppl 1), 15–20.  https://doi.org/10.1080/16506070902980703.CrossRefPubMedGoogle Scholar
  2. Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., et al. (2004). Mindfulness: a proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230–241.  https://doi.org/10.1093/clipsy.bph077.CrossRefGoogle Scholar
  3. Bohlmeijer, E., Prenger, R., Taal, E., & Cuijpers, P. (2010). The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. Journal of Psychosomatic Research, 68(6), 539–544.  https://doi.org/10.1016/j.jpsychores.2009.10.005.CrossRefPubMedGoogle Scholar
  4. Branstetter-Rost, A., Cushing, C., & Douleh, T. (2009). Personal values and pain tolerance: does a values intervention add to acceptance? The Journal of Pain, 10(8), 887–892.  https://doi.org/10.1016/j.jpain.2009.01.001.CrossRefPubMedGoogle Scholar
  5. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.  https://doi.org/10.3758/bf03193146.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Feldner, M. T., Hekmat, H., Zvolensky, M. J., Vowles, K. E., Secrist, Z., & Leen-Feldner, E. W. (2006). The role of experiential avoidance in acute pain tolerance: a laboratory test. Journal of Behavior Therapy and Experimental Psychiatry, 37(2), 146–158.  https://doi.org/10.1016/j.jbtep.2005.03.002.CrossRefPubMedGoogle Scholar
  7. Forsyth, L., & Hayes, L. L. (2014). The effects of acceptance of thoughts, mindful awareness of breathing, and spontaneous coping on an experimentally induced pain task. The Psychological Record, 64(3), 447–455.  https://doi.org/10.1007/s40732-014-0010-6.CrossRefGoogle Scholar
  8. Frewen, P. A., Evans, E. M., Maraj, N., Dozois, D. J. A., & Partridge, K. (2007). Letting go: mindfulness and negative automatic thinking. Cognitive Therapy and Research, 32(6), 758–774.  https://doi.org/10.1007/s10608-007-9142-1.CrossRefGoogle Scholar
  9. Frewen, P. A., Lundberg, E., MacKinley, J., & Wrath, A. (2011). Assessment of response to mindfulness meditation: meditation breath attention scores in association with subjective measures of state and trait mindfulness and difficulty letting go of depressive cognition. Mindfulness, 2(4), 254–269.  https://doi.org/10.1007/s12671-011-0069-y.CrossRefGoogle Scholar
  10. Gao, L., Curtiss, J., Liu, X., & Hofmann, S. (2018). Differential treatment mechanisms in mindfulness meditation and progressive muscle relaxation. Mindfulness, 9(4), 1268–1279.CrossRefGoogle Scholar
  11. Grant, J. A. (2014). Meditative analgesia: the current state of the field. Annals of the New York Academy of Sciences, 1307, 55–63.  https://doi.org/10.1111/nyas.12282.CrossRefPubMedGoogle Scholar
  12. Grant, J. A., & Rainville, P. (2009). Pain sensitivity and analgesic effects of mindful states in Zen meditators: a cross-sectional study. Psychosomatic Medicine, 71(1), 106–114.  https://doi.org/10.1097/PSY.0b013e31818f52ee.CrossRefPubMedGoogle Scholar
  13. Gutiérrez, O., Luciano, C., Rodríguez, M., & Fink, B. C. (2004). Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain. Behavior Therapy, 35(4), 767–783.CrossRefGoogle Scholar
  14. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy. New York: The Guilford Press.Google Scholar
  15. Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156.  https://doi.org/10.1093/clipsy.bpg016.CrossRefGoogle Scholar
  16. Keogh, E., Bond, F. W., Hanmer, R., & Tilston, J. (2005). Comparing acceptance- and control-based coping instructions on the cold-pressor pain experiences of healthy men and women. European Journal of Pain, 9(5), 591–598.  https://doi.org/10.1016/j.ejpain.2004.12.005.CrossRefPubMedGoogle Scholar
  17. Kingston, J., Chadwick, P., Meron, D., & Skinner, T. C. (2007). A pilot randomized control trial investigating the effect of mindfulness practice on pain tolerance, psychological well-being, and physiological activity. Journal of Psychosomatic Research, 62(3), 297–300.  https://doi.org/10.1016/j.jpsychores.2006.10.007.CrossRefPubMedGoogle Scholar
  18. Kohl, A., Rief, W., & Glombiewski, J. A. (2012). How effective are acceptance strategies? A meta-analytic review of experimental results. Journal of Behavior Therapy and Experimental Psychiatry, 43(4), 988–1001.  https://doi.org/10.1016/j.jbtep.2012.03.004.CrossRefPubMedGoogle Scholar
  19. Kohl, A., Rief, W., & Glombiewski, J. A. (2013). Acceptance, cognitive restructuring, and distraction as coping strategies for acute pain. Journal of Pain, 14(3), 305–315.  https://doi.org/10.1016/j.jpain.2012.12.005.CrossRefPubMedGoogle Scholar
  20. Lindsay, E. K., & Creswell, J. D. (2017). Mechanisms of mindfulness training: monitor and acceptance theory (MAT). Clinical Psychology Review, 51, 48–59.  https://doi.org/10.1016/j.cpr.2016.10.011.CrossRefPubMedGoogle Scholar
  21. Liu, X., Wang, S., Chang, S., Chen, W., & Si, M. (2013). Effect of brief mindfulness intervention on tolerance and distress of pain induced by cold-pressor task. Stress and Health, 29(3), 199–204.  https://doi.org/10.1002/smi.2446.CrossRefPubMedGoogle Scholar
  22. Masedo, A. I., & Esteve, M. R. (2007). Effects of suppression, acceptance and spontaneous coping on pain tolerance, pain intensity and distress. Behaviour Research and Therapy, 45(2), 199–209.  https://doi.org/10.1016/j.brat.2006.02.006.CrossRefPubMedGoogle Scholar
  23. McCaul, K. D., & Haugtvedt, C. (1982). Attention, distraction, and cold-pressor pain. Journal of Personality and Social Psychology, 43(1), 154–162.  https://doi.org/10.1037/0022-3514.43.1.154.CrossRefPubMedGoogle Scholar
  24. McCracken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy, 43(10), 1335–1346.  https://doi.org/10.1016/j.brat.2004.10.003.CrossRefPubMedGoogle Scholar
  25. McMullen, J., Barnes-Holmes, D., Barnes-Holmes, Y., Stewart, I., Luciano, C., & Cochrane, A. (2008). Acceptance versus distraction: brief instructions, metaphors and exercises in increasing tolerance for self-delivered electric shocks. Behaviour Research and Therapy, 46(1), 122–129.  https://doi.org/10.1016/j.brat.2007.09.002.CrossRefPubMedGoogle Scholar
  26. Mitchell, L. A., MacDonald, R. A., & Brodie, E. E. (2004). Temperature and the cold pressor test. Journal of Pain, 5(4), 233–237.  https://doi.org/10.1016/j.jpain.2004.03.004.CrossRefPubMedGoogle Scholar
  27. Roche, B., Forsyth, J. P., & Maher, E. (2007). The impact of demand characteristics on brief acceptance- and control-based interventions for pain tolerance. Cognitive and Behavioral Practice, 14(4), 381–393.  https://doi.org/10.1016/j.cbpra.2006.10.010.CrossRefGoogle Scholar
  28. Veehof, M. M., Oskam, M. J., Schreurs, K. M., & Bohlmeijer, E. T. (2011). Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain, 152(3), 533–542.  https://doi.org/10.1016/j.pain.2010.11.002. CrossRefPubMedGoogle Scholar
  29. Wang, Y., Xu, W., Zhuang, C., & Liu, X. (2017). Does mind wandering mediate the association between mindfulness and negative mood? A preliminary study. Psychological Reports, 120(1), 118–129.  https://doi.org/10.1177/0033294116686036.CrossRefPubMedGoogle Scholar
  30. Zeidan, F., & Vago, D. R. (2016). Mindfulness meditation-based pain relief: a mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114–127.  https://doi.org/10.1111/nyas.13153.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Zeidan, F., Gordon, N. S., Merchant, J., & Goolkasian, P. (2010). The effects of brief mindfulness meditation training on experimentally induced pain. Journal of Pain, 11(3), 199–209.  https://doi.org/10.1016/j.jpain.2009.07.015.CrossRefPubMedGoogle Scholar
  32. Zeidan, F., Grant, J. A., Brown, C. A., McHaffie, J. G., & Coghill, R. C. (2012). Mindfulness meditation-related pain relief: evidence for unique brain mechanisms in the regulation of pain. Neuroscience Letters, 520(2), 165–173.  https://doi.org/10.1016/j.neulet.2012.03.082.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Beijing Key Laboratory of Learning and Cognition, Department of PsychologyCapital Normal UniversityBeijingChina
  2. 2.CAS Key Laboratory of Mental Health, Institute of PsychologyChinese Academy of SciencesBeijingChina
  3. 3.Department of Psychological and Brain SciencesBoston UniversityBostonUSA
  4. 4.Department of Cognitive ScienceRensselaer Polytechnic InstituteTroyUSA
  5. 5.Beijing Key Laboratory of Behavior and Mental Health, School of Psychological and Cognitive SciencesPeking UniversityBeijingChina
  6. 6.School of PsychologyNanjing Normal UniversityNanjingChina

Personalised recommendations