Internet-delivered mindfulness for people with depression and chronic pain following spinal cord injury: a randomized, controlled feasibility trial

• Published in: Spinal cord Vol. 56; no. 8; pp. 750 - 761
• Main Authors: Hearn, Jasmine Heath, Finlay, Katherine Anne
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.08.2018; Nature Publishing Group
• Subjects: 631/477/2811; 692/699/375/1692; 692/699/375/1824; 692/700/784; Anatomy; Anxiety; Biomedical and Life Sciences; Biomedicine; Chronic pain; Feasibility studies; Human Physiology; Internet; Intervention; Mental depression; Neurochemistry; Neuropsychology; Neurosciences; Pain; Pain perception; Population studies; Quality of life; Randomization; Sampling methods; Spinal cord injuries; Training
• ISSN: 1362-4393; 1476-5624; 1476-5624
• DOI: 10.1038/s41393-018-0090-2

Study design Between-subjects, randomized controlled feasibility study. Objectives Populations with reduced sensory and motor function are at increased risk of depression, anxiety and pain, and may be less geographically mobile. This study explored the efficacy and feasibility of web-based mindfulness training for people with spinal cord injury (SCI). Setting UK community sample. Methods Participants were randomly allocated to an 8-week online mindfulness intervention ( N   =  36), or to internet-delivered psychoeducation ( N   =  31). Depression symptom severity was the primary outcome. Secondary outcomes included anxiety, quality of life (QoL), pain perception, pain catastrophizing and mindfulness. Measures were taken before (T1), at completion of, (T2), and 3 months following the intervention (T3). Results At T2, ten participants discontinued mindfulness training, and five discontinued psychoeducation. Dropouts were of significantly older age. Nine participants were lost to follow-up. Mindfulness reduced depression significantly more than psychoeducation at T2 (mean difference = −1.50, 95% CI [−2.43, −0.58]) and T3 (mean difference = −2.34, 95% CI [−3.62, −1.10]). Anxiety, pain unpleasantness and catastrophizing were significantly reduced compared with psychoeducation. Total mindfulness scores, and all facets of mindfulness except observing were significantly higher following mindfulness training. At follow-up, reductions in anxiety and catastrophizing persisted. Conclusions Internet-delivered mindfulness training offers unique benefits and is viable for people with reduced sensory awareness. Future work should explore the feasibility of combined education and mindfulness training. The use of brief interventions shows promise in maximizing participant retention.