Feasibility and Acceptability of a Four-week Mindfulness-Based Cognitive Therapy Intervention for the Treatment of Pain Catastrophizing in Multiple Sclerosis

Abstract

Chronic pain is highly prevalent in multiple sclerosis (MS) populations, frequently difficult to treat, negatively interferes with numerous areas of functionality and health, and is under-treated and under-studied in MS. Pain catastrophizing is consistently found to be related to intensity of chronic pain in both MS and non-MS populations, and can influence physical pain through spinal gating mechanisms, as well as the affective-motivational and cognitive-evaluative facets of chronic pain. The objective of the present study was to evaluate the feasibility and acceptability of treating pain catastrophizing using a four-week mindfulness-based cognitive therapy (MBCT) intervention, which has been effective in treating pain and pain catastrophizing in non-MS populations. Participants (N= 53) were recruited from the MS Center at Holy Name Medical Center. Participants who completed the groups ( N= 22) were primarily in middle adulthood, Caucasian, and female, received at least some college education, experienced pain of predominantly neuropathic origin, and were diagnosed with the relapsing-remitting MS subtype. Feasibility and acceptability were evaluated using data regarding dropout rates, as well as qualitative data. Preliminary effectiveness of the intervention was also evaluated by comparing the MBCT group to a control group that received an equivalent amount of supportive group therapy. Results suggest that, despite some barriers to treatment, a four-week MBCT group intervention is generally feasible and acceptable treatment approach for pain catastrophizing in at least some patients with MS. Qualitative responses suggests that those in the intervention group learned more skills to manage and accept pain than in the support group. However, preliminary quantitative analysis of effectiveness was not statistically significant, suggesting that more research is necessary to determine if an MBCT group is more beneficial than a support group for treating pain catastrophizing in MS. The present study indicates that a four-week MBCT intervention is feasible and acceptable for at least some patients with MS and pain, which could have implications for improving quality of life, numerous areas of functioning, and overall mental and physical health.