{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:58:21Z","timestamp":1772517501441,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K18983"],"award-info":[{"award-number":["JP23K18983"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP18K07476"],"award-info":[{"award-number":["JP18K07476"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Labor Sciences Research Grant","award":["19FG1001"],"award-info":[{"award-number":["19FG1001"]}]},{"DOI":"10.13039\/100020709","name":"Mental Health Okamoto Memorial Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100020709","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Mindfulness-Based Cognitive Therapy (MBCT) is a well-documented treatment option for chronic pain. However, few studies have examined the emotional state experienced by participants with chronic pain during the sessions. This study aimed to assess the trajectory of mood experiences in an MBCT program and evaluate the effect on temporal mood state. Methods: The Temporary Mood Scale (TMS) was used to assess vigor, fatigue, anger-hostility, depression-dejection, tension-anxiety, and confusion before and after each MBCT session from July 2018 to May 2019. A total of 33 patients with chronic pain who attended the MBCT program were included in the study. A mixed-effect model was used to identify single-session and overall effects on each mood state. Pearson\u2019s correlation analysis was used to examine the associations between changes in the six mood states and baseline conditions, including pain-related factors. Results: The mixed-effect model identified significant improvements in single-session effects on all mood states (p &lt; 0.001). Significant overall effects were identified on vigor (p &lt; 0.01), depression-dejection (p &lt; 0.01), tension-anxiety (p &lt; 0.001), and confusion (p &lt; 0.05) states throughout the sessions. Moreover, participants with higher tension-anxiety at baseline showed significantly greater improvements in anger-hostility (p &lt; 0.05), depression-dejection (p &lt; 0.01), tension-anxiety (p &lt; 0.05), and confusion (p &lt; 0.01). Conclusions: Individual sessions and the overall MBCT program significantly improved the mood states of patients with chronic pain. Patients with higher tension-anxiety are likely to be effective treatment targets for MBCT programs.<\/jats:p>","DOI":"10.3390\/jcm15051839","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T10:24:34Z","timestamp":1772447074000},"page":"1839","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Mindfulness-Based Cognitive Therapy on Trajectory of Mood States in Patients with Chronic Pain: A Retrospective Observational Study of Within-Session Evaluations"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1737-5573","authenticated-orcid":false,"given":"Chisato","family":"Tanaka","sequence":"first","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Shinohara","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3986-9012","authenticated-orcid":false,"given":"Saki","family":"Takaoka","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morihiko","family":"Kawate","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2121-7404","authenticated-orcid":false,"given":"Yuki","family":"Mashima","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-8056","authenticated-orcid":false,"given":"Reiko","family":"Hoshino","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1913-6955","authenticated-orcid":false,"given":"Daisuke","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shizuko","family":"Kosugi","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4884-6251","authenticated-orcid":false,"given":"Kenta","family":"Wakaizumi","sequence":"additional","affiliation":[{"name":"Interdisciplinary Pain Center, Keio University Hospital, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/j.pain.0000000000001390","article-title":"The IASP classification of chronic pain for ICD-11","volume":"160","author":"Nicholas","year":"2019","journal-title":"Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1097\/j.pain.0000000000002557","article-title":"A global study of pain prevalence across 52 countries: Examining the role of country-level contextual factors","volume":"163","author":"Zimmer","year":"2022","journal-title":"Pain"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Goldberg, D.S., and McGee, S.J. (2011). Pain as a global public health priority. BMC Public Health, 11.","DOI":"10.1186\/1471-2458-11-770"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.pnpbp.2019.04.006","article-title":"The silent epidemic of chronic pain in older adults","volume":"93","author":"Domenichiello","year":"2019","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1002\/ejp.2234","article-title":"The costs of chronic pain-Long-term estimates","volume":"28","author":"Stubhaug","year":"2024","journal-title":"Eur. J. Pain"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1097\/j.pain.0000000000003149","article-title":"Productivity outcomes from chronic pain man-agement interventions in the working age population; a systematic review","volume":"165","author":"Chowdhury","year":"2024","journal-title":"Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1879","DOI":"10.2147\/JPR.S197533","article-title":"How does reduction in pain lead to reduction in disability in patients with musculoskeletal pain?","volume":"12","author":"Shaygan","year":"2019","journal-title":"J. Pain Res."},{"key":"ref_8","first-page":"3","article-title":"Living well with chronic pain: The role of pain-management programmes","volume":"18","author":"Brook","year":"2017","journal-title":"BJA Educ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.2147\/JPR.S177231","article-title":"Impact of a multidisciplinary pain management program on patient care utilization and cost of care","volume":"11","author":"Maeng","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1111\/j.1526-4637.2009.00659.x","article-title":"Cost-Effectiveness of Multidisciplinary Pain Treatment: Are We There Yet?","volume":"10","author":"Clark","year":"2009","journal-title":"Pain Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3399\/bjgp22X719453","article-title":"NICE chronic primary pain guidelines: What the busy GP needs to know","volume":"72","author":"Higginbottom","year":"2022","journal-title":"Br. J. Gen. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e067718","DOI":"10.1136\/bmj-2021-067718","article-title":"Psychological interventions for chronic, non-specific low back pain: Systematic review with network meta-analysis","volume":"376","author":"Ho","year":"2022","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"20m13740","DOI":"10.4088\/JCP.20m13740","article-title":"Cross-Sectional Associations Among Symptoms of Pain, Irritability, and Depression and How These Symptoms Relate to Social Functioning and Quality of Life: Findings From the EMBARC and STRIDE Studies and the VitalSign6Project","volume":"82","author":"Jha","year":"2021","journal-title":"J. Clin. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1097\/PSY.0000000000000158","article-title":"Longitudinal associations between depression, anxiety, pain, and pain-related disability in chronic pain patients","volume":"77","author":"Lerman","year":"2015","journal-title":"Psychosom. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1037\/0278-6133.26.1.1","article-title":"Meta-analysis of psychological interventions for chronic low back pain","volume":"26","author":"Hoffman","year":"2007","journal-title":"Health Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1097\/00007632-200010150-00024","article-title":"Behavioral treatment for chronic low back pain: A systematic review within the framework of the Cochrane Back Review Group","volume":"25","author":"Ostelo","year":"2000","journal-title":"Spine"},{"key":"ref_17","first-page":"CD007407","article-title":"Psychological therapies for the management of chronic pain (excluding headache) in adults","volume":"11","author":"Williams","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","first-page":"CD000963","article-title":"Multidisciplinary bio-psycho-social reha-bilitation for chronic low back pain","volume":"1","author":"Guzman","year":"2002","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1177\/070674371205700202","article-title":"Mindfulness-based cognitive therapy: Theory and practice","volume":"57","author":"Sipe","year":"2012","journal-title":"Can. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1093\/clipsy.bpg016","article-title":"Mindfulness-Based Interventions in Context: Past, Present, and Future","volume":"10","year":"2003","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1093\/clipsy.bph077","article-title":"Mindfulness: A Proposed Operational Definition","volume":"11","author":"Bishop","year":"2004","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"de Jong, M., Lazar, S.W., Hug, K., Mehling, W.E., H\u00f6lzel, B.K., Sack, A.T., Peeters, F., Ashih, H., Mischoulon, D., and Gard, T. (2016). Effects of mindfulness-based cognitive therapy on body awareness in patients with chronic pain and comorbid depression. Front. Psychol., 7.","DOI":"10.3389\/fpsyg.2016.00967"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1037\/a0038200","article-title":"Mindfulness and Cognitive-behavioral Interventions for Chronic Pain: Differential Effects on Daily Pain Reactivity and Stress Reactivity","volume":"83","author":"Davis","year":"2014","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1177\/02537176241249375","article-title":"The Efficacy and Durability of Mindfulness-Based Cognitive Therapy in the Treatment of Anxiety and Depressive Disorders: A Systematic Review and Meta-analysis","volume":"47","author":"Nandarathana","year":"2024","journal-title":"Indian J. Psychol. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.brat.2016.12.007","article-title":"Patients\u2019 in-session experiences and symptom change: Session-to-session effects on a within- and between-patient level","volume":"90","author":"Rubel","year":"2017","journal-title":"Behav. Res. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1007\/s12671-018-0897-0","article-title":"The Safety of Mindfulness-Based Interventions: A Systematic Review of Randomized Controlled Trials","volume":"9","author":"Wong","year":"2018","journal-title":"Mindfulness"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/00002508-200501000-00003","article-title":"Treatment expectancy affects the outcome of cognitive-behavioral interventions in chronic pain","volume":"21","author":"Goossens","year":"2005","journal-title":"Clin. J. Pain"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1001\/jamapsychiatry.2016.0076","article-title":"Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials","volume":"73","author":"Kuyken","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Sultson, H., Murd, C., Havik, M., and Konstabel, K. (2024). Negative affect instability predicts elevated depressive and generalized anxiety disorder symptoms even when negative affect intensity is controlled for: An ecological momentary assessment study. Front. Psychol., 15.","DOI":"10.3389\/fpsyg.2024.1371115"},{"key":"ref_30","first-page":"1","article-title":"The Validity of Temporary Mood Scale","volume":"22","author":"Kanji","year":"2011","journal-title":"Ritsumeikan J. Hum. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1037\/0033-2909.133.4.581","article-title":"The Biopsychosocial Approach to Chronic Pain: Scientific Advances and Future Directions","volume":"133","author":"Gatchel","year":"2007","journal-title":"Psychol. Bull."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1586\/ern.09.34","article-title":"Pain catastrophizing: A critical review","volume":"9","author":"Quartana","year":"2009","journal-title":"Expert. Rev. Neurother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/AJP.0b013e3182385392","article-title":"Fear-avoidance model of chronic pain: The next generation","volume":"28","author":"Crombez","year":"2012","journal-title":"Clin. J. Pain."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1007\/s11136-018-1794-7","article-title":"Activity pacing: Moving beyond taking breaks and slowing down","volume":"27","author":"Antcliff","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_35","first-page":"913","article-title":"Production of the Japanese edition of profile of mood states (POMS): Assessment of reliability and validity","volume":"37","author":"Yokoyama","year":"1990","journal-title":"Nihon Koshu Eisei Zasshi"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1136\/ard.37.4.378","article-title":"Studies with pain rating scales","volume":"37","author":"Downie","year":"1978","journal-title":"Ann. Rheum. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1111\/j.1365-2702.2005.01121.x","article-title":"Pain: A review of three commonly used pain rating scales","volume":"14","author":"Williamson","year":"2005","journal-title":"J. Clin. Nurs."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1477-7525-7-42","article-title":"Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations","volume":"7","author":"Matsudaira","year":"2009","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1037\/1040-3590.7.4.524","article-title":"The Pain Catastrophizing Scale: Development and Validation","volume":"7","author":"Sullivan","year":"1995","journal-title":"Psychol. Assess."},{"key":"ref_41","first-page":"95","article-title":"Assessment of Cognitive Aspect of Pain: Development, Reliability, and Validation of Japanese Version of Pain Catastrophizing Scale","volume":"47","author":"Matsuoka","year":"2007","journal-title":"Jpn. J. Psychosom. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1097\/j.pain.0000000000001494","article-title":"Meta-analysis of the psychometric properties of the Pain Catastrophizing Scale and associations with participant characteristics","volume":"160","author":"Wheeler","year":"2019","journal-title":"Pain"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.ejpain.2005.12.008","article-title":"The pain self-efficacy questionnaire: Taking pain into account","volume":"11","author":"Nicholas","year":"2007","journal-title":"Eur. J. Pain"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1111\/pme.12446","article-title":"Validation of the Japanese version of the pain self-efficacy questionnaire in Japanese patients with chronic pain","volume":"15","author":"Adachi","year":"2014","journal-title":"Pain Med."},{"key":"ref_45","first-page":"7","article-title":"Pain Disability Assessment Scale (PDAS): A Simplified Scale for Clinical Use","volume":"23","author":"Arimura","year":"1997","journal-title":"Jpn. J. Behav. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0005-7916(00)00012-4","article-title":"Psychometric properties of the credibility\/expectancy questionnaire","volume":"31","author":"Devilly","year":"2000","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.smrv.2017.08.001","article-title":"Effects of sleep changes on pain-related health outcomes in the general population: A systematic review of longitudinal studies with exploratory meta-analysis","volume":"39","author":"Afolalu","year":"2018","journal-title":"Sleep Med. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/pcn.12073","article-title":"Development and validation of the Japanese version of the Athens Insomnia Scale","volume":"67","author":"Okajima","year":"2013","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"EuroQol Group (1990). EuroQol\u2014A new facility for the measurement of health-related quality of life. Health Policy, 16, 199\u2013208.","DOI":"10.1016\/0168-8510(90)90421-9"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","article-title":"Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)","volume":"20","author":"Herdman","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_51","first-page":"47","article-title":"Developing a Japanese version of the EQ-5D-5L value set","volume":"64","author":"Ikeda","year":"2015","journal-title":"J. Natl. Inst. Public Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s11136-015-1108-2","article-title":"Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D","volume":"25","author":"Shiroiwa","year":"2016","journal-title":"Qual. Life Res."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s12199-010-0162-1","article-title":"Evaluation of health-related quality of life using EQ-5D in Takamatsu, Japan","volume":"16","author":"Fujikawa","year":"2010","journal-title":"Environ. Health Prev. Med."},{"key":"ref_54","first-page":"147","article-title":"Mindfulness-based cognitive therapy for depression, second edition","volume":"28","author":"Segal","year":"2014","journal-title":"J. Cogn. Psychother."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1590\/S0104-11692012000500011","article-title":"Effects of a psy-choeducational program for chronic pain management","volume":"20","author":"Salvetti","year":"2012","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/acps.13225","article-title":"Adverse events in meditation practices and meditation-based therapies: A systematic review","volume":"142","author":"Farias","year":"2020","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1007\/s12671-019-1091-8","article-title":"Effect of Acceptance versus Attention on Pain Tolerance: Dissecting Two Components of Mindfulness","volume":"10","author":"Wang","year":"2019","journal-title":"Mindfulness"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1515\/sjpain-2022-0107","article-title":"Pain acceptance and psychological inflexibility predict pain interference outcomes for persons with chronic pain receiving pain psychology","volume":"23","author":"Karayannis","year":"2023","journal-title":"Scand. J. Pain"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"111954","DOI":"10.1016\/j.paid.2022.111954","article-title":"Self-compassion manipulation regulates affect and aggressive inclinations in the context of social rejection","volume":"201","author":"Miyagawa","year":"2023","journal-title":"Pers. Individ. Differ."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.neubiorev.2008.12.003","article-title":"Pain-related effects of trait anger expression: Neural substrates and the role of endogenous opioid mechanisms","volume":"33","author":"Bruehl","year":"2009","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jpain.2012.04.006","article-title":"Mechanical and Heat Hyperalgesia Highly Predict Clinical Pain Intensity in Patients With Chronic Musculoskeletal Pain Syndromes","volume":"13","author":"Staud","year":"2012","journal-title":"J. Pain"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Dahmani, D., Taik, F.Z., Berrichi, I., Fourtassi, M., and Abourazzak, F.E. (2023). Impact of central sensitization on pain, disability and psychological distress in patients with knee osteoarthritis and chronic low back pain. BMC Musculoskelet. Disord., 24.","DOI":"10.1186\/s12891-023-07019-z"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2164957X221096640","DOI":"10.1177\/2164957X221096640","article-title":"What Are Adverse Events in Mindfulness Meditation?","volume":"11","author":"Binda","year":"2022","journal-title":"Glob. Adv. Health Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"104425","DOI":"10.1016\/j.brat.2023.104425","article-title":"On the Importance of Identifying Mechanisms and Active Ingredients of Psychological Treatments","volume":"170","author":"Tolin","year":"2023","journal-title":"Behav. Res. Ther."},{"key":"ref_65","first-page":"325","article-title":"Detecting alliance ruptures: The effects of the therapist\u2019s experience, attachment, empathy and countertransference management skills","volume":"22","author":"Talbot","year":"2019","journal-title":"Res. Psychother. Psy-Chopathology Process Outcome"},{"key":"ref_66","first-page":"215","article-title":"Mindfulness intervention in the management of chronic pain and psycho-logical comorbidity: A meta-analysis","volume":"1","author":"Song","year":"2014","journal-title":"Int. J. Nurs. Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/ptj\/82.4.383","article-title":"Tissue adaptation to physical stress: A proposed \u201cPhysical Stress Theory\u201d to guide physical therapist practice, education, and research","volume":"82","author":"Mueller","year":"2002","journal-title":"Phys. Ther."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e770","DOI":"10.1097\/PR9.0000000000000770","article-title":"The relationship between guarding, pain, and emotion","volume":"4","author":"Olugbade","year":"2019","journal-title":"Pain Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2164956120905597","DOI":"10.1177\/2164956120905597","article-title":"A Perspective on the Similarities and Differences Between Mindfulness and Relaxation","volume":"9","author":"Luberto","year":"2020","journal-title":"Glob. Adv. Health Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1037\/a0018555","article-title":"The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review","volume":"78","author":"Hofmann","year":"2010","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1007\/s10865-011-9379-8","article-title":"The impact of emotional well-being on long-term recovery and survival in physical illness: A meta-analysis","volume":"35","author":"Lamers","year":"2012","journal-title":"J. Behav. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1839\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:19:10Z","timestamp":1772515150000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":71,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15051839"],"URL":"https:\/\/doi.org\/10.3390\/jcm15051839","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]}}}