Mindfulness Is Associated with Reduced Anhedonia Among Chronic Pain Patients

Background and Purpose:  While Americans are increasingly living longer, the prevalence of chronic pain conditions is also rising, with at least 116 million U.S. adults reporting that they suffer from at least one chronic pain condition.  This is more than the number affected by heart disease, diabetes and cancer combined, indicating that for many the quality of those extended years may be far less than ideal.  Chronic pain is a disabling disorder that is frequently accompanied by the presence of anhedonia.   The functional impairment caused by a chronic pain condition and the lack of interest and enjoyment that characterizes anhedonia interact to reduce engagement in valued living activities and decrease eudaimonic life satisfaction.  In this study we examine aspects of dispositional mindfulness, including broadened awareness and increased conscious observation of pleasurable experiences, and their potential to counter this negative feedback loop, thereby increasing hedonic pleasure in everyday life.

Methods:  Data used for this study was drawn from a sample of 115 chronic pain patients (37 males and 78 females) ranging in age from 20-84 years (M=48.3, SD=13.6) who voluntarily completed a series of validated self-report measures, including the Five Facet Mindfulness Questionnaire (FFMQ) and the Snaith-Hamilton Anhedonia and Pleasure Scale (SHAPS).  A bivariate correlation was first conducted in order to determine the presence of a relationship between mindfulness (FFMQ) and increased pleasure/reduced anhedonia (SHAPS).  A hierarchical multiple regression analysis was then conducted in order to determine if FFMQ scores could be used to predict the variance in SHAPS scores.  Confounding variables, including pain severity, pain interference, and a diagnosis of Major Depressive Disorder (MDD), were factored into the model in order to reduce the likelihood of spurious results.  Finally an additional multiple regression analysis was conducted in order to identify which factor of mindfulness predicted the most variance in pleasure/anhedonia. 

Results:  There was a significant zero-order correlation between FFMQ and SHAPS scores, r=.33, p<.001.  Results of hierarchical regression analysis indicated that FFMQ scores explained 21% of the variance in SHAPS scores (F(3,92)=6.05, p<.001) after statistically controlling for pain severity, pain interference and depression.  Further analysis revealed that the observe facet of mindfulness had the strongest association with the experience of pleasure, t(3)=2.52, p<.05.

Conclusions and Implications:  Findings of this study indicate that among chronic pain patients, dispositional mindfulness is positively associated with the experience of pleasure in everyday life, and that the observe facet, or attentiveness to both internal and external stimuli, plays the most significant role in this influence.   This is the first finding in the scientific literature of an association between dispositional mindfulness and the experience of pleasure in daily life.  In light of the inverse association between mindfulness and anhedonia in this sample, it is plausible that mindfulness training may improve quality of life among chronic pain suffers by enhancing hedonic pleasure. To test this hypothesis, randomized controlled studies are needed that include psychophysiological measures rather than solely rely on self-report data.