The impact of mindfulness versus attention training on pain outcomes: What moderates the efficacy?

This is a three arm design. There are two brief (single session) interventions [both less than 15 minutes in instruction]: Mindfulness interoceptive exposure task and Attention Training Task; and a no treatment control group (see below). The MIET The Mindfulness-based Interoceptive Exposure Task (MIET) was developed as part of a broader mindfulness-integrated cognitive behavioural therapy approach. The purpose of MIET is to get participants to focus on painful sensations, but in a way that promotes the reappraising of the interoceptive experience of pain in terms of 4 characteristics of body sensations (mass, temperature, motion and cohesiveness/constriction). The aim of this strategy is to prevent participants from judgement of their interoceptive experience in order to decrease the activation of mental representations of pain and related distress and thereby minimize self-referential processing. This study used the Mindfulness-based interoceptive exposure task (MIET) in a 2 minute script which was recorded on an MP3 device and played through headphones to participants. Participants were instructed to close their eyes and focus non-judgmental attention on the most intense pain sensation felt at that moment and monitor the potential changes that may take place in 4 fundamental characteristics. They were instructed to utilise this same approach when placing their arm in the cold pressor. The Attention Training Task: The ATT is a task that aims to train attention through listening to a sound array while being given instructions about which sound(s) to listen to. Throughout the ATT task, participants were directed through three attention tasks: selective attention, in which participants focused on one specific sound; switching attention, in which participants were required to focus on a specific sound and then another in rapid succession; and divided attention, in which participants were instructed to focus on as many different sounds as they could at once. In addition to being directed to focus their attention on sounds on the audio (e.g. bells, traffic, birds, running water), participants were to focus their attention on sounds in the room that were behind them, to their left and to their right. Therefore, the volume of the audio was set at a moderate level so that participants could also attend to any sounds in the background. The humming of the cold pressor apparatus, a small clock radio playing classical music and the tapping of a pen by the experimenter served as background noises, and were at a volume comparable to the sounds on the audio.