Pain-Related Anxiety as a Mediator of the Effects of Mindfulness on Physical and Psychosocial Functioning in Chronic Pain Patients in Korea

Mindfulness involves reducing potential influences from aversive cognitions, sensations, and emotions on behavior. Mindfulness may influence the experience of pain-related anxiety, and thereby enhance other aspects of physical and psychosocial functioning. Thus, the purpose of this study was to investigate a potential mediating role of pain-related anxiety between mindfulness and physical and psychosocial functioning in chronic pain patients. This cross-sectional/correlational study used archival data (N = 226) obtained from the larger Korean Pain Study at a university-based pain-management center in Korea. Based on the inclusion criterion for the present study, archival data were analyzed for a final sample of 179 patients with chronic pain. Structural equation analyses showed that both the partial- and full-mediation models had adequate goodness-of-fit indices for physical and psychosocial functioning. Subsequent chi-square tests, however, indicated that the more parsimonious full-mediation model was preferred to the partial-mediation model for physical and psychosocial functioning. Bootstrapping procedures yielded significant mediation effects of pain-related anxiety in the full-mediation models on physical and psychosocial functioning. These findings suggest that being mindful may lead indirectly to a decrease in the disabling influences of pain-related anxiety, thereby contributing to better physical and psychosocial functioning, rather than playing a direct contributing role for better functioning among chronic pain patients in Korea. Perspective: This article examines the mediating role of pain-related anxiety between mindfulness and physical/psychosocial functioning. Results suggest that mindfulness methods may benefit pa- tients having pain-related anxiety and consequent disability. These benefits may derive from the way processes of mindfulness interact with processes of avoidance and with cognitive influences on emotional suffering.