Age, Pain Intensity, Values-Discrepancy, and Mindfulness as Predictors for Mental Health and Cognitive Fusion: Hierarchical Regressions With Mediation Analysis.

Darren J Edwards

doi:10.3389/fpsyg.2019.00517

Abstract

Background: Several studies have confirmed that higher levels of psychological flexibility predict better functioning for those suffering with chronic pain. However, few studies have investigated the role of the individual components of psychological flexibility within a chronic pain population in relation to aging specifically and the related indirect mediational processes.Aim: The present study aimed to compare how age, pain intensity, mindfulness, and values-discrepancy predicted mental health and cognitive fusion separately. It also explored the indirect process relations through the use of a mediated analysis.Methods: Two hundred and thirty three participants completed an online survey which included demographical questions as well as the following questionnaires; Short Form McGill Pain Questionnaire (SF-MPQ); General Health Questionnaire 12; Cognitive Fusion 7-Item Questionnaire (CFQ-7); Mindfulness Attention Awareness Scale (MAAS); and the Chronic Pain Values Inventory (CPVI). The relationships from the responses of the questionnaires and demographics were then analyzed through two hierarchical regression models followed by further mediation analysis.Results: In the first model, values-discrepancy, pain intensity, and mindfulness all predicted mental health, but age did not. However, age did account for a significant portion of the variance in the second model when cognitive fusion was used as the dependent measure. It was also found that cognitive fusion mediated the relationship between age and mental health.Conclusion: These results are discussed within the context of using indirect process relations of psychological flexibility and third wave therapies such as acceptance and commitment therapy for a chronic pain population.

Highlights

Chronic pain represents a major health problem internationally
Age positively correlated with mindfulness, values success, and negatively with mental health and cognitive fusion
The findings revealed that age predicted cognitive fusion independently of predictors; values-discrepancy, mindfulness, and pain intensity in the first hierarchal regression

Summary

Introduction

Chronic pain represents a major health problem internationally. For example, approximately 30–50% of individuals will suffer clinically significant neck-pain annually (Hogg-Johnson et al, 2008; Fernández-de-las-Peñas et al, 2011), and 50% of the United Kingdom population will suffer, at least once, an instance of shoulder pain (Hand et al, 2008). One explanation as to why this relationship exists arrives in form of psychological inflexibility This can be defined as being excessively entangled in experiential avoidance as a result being cognitively fused, lacking acceptance and openness to painful thoughts and feelings, disconnected from the present moment, and without commitment to living in accordance with personal values (Ciarrochi et al, 2010). The individual may attempt to avoid situations and thoughts that are deemed painful at the expense of valued living. This individual may adopt rigid behavior patterns which are not aligned to values. Few studies have investigated the role of the individual components of psychological flexibility within a chronic pain population in relation to aging and the related indirect mediational processes

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