Neural activations during self-related processing in patients with chronic pain and effects of a brief self-compassion training - A pilot study.

Autor: Lutz J; Department of Radiology, Harvard Medical School, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St., Charlestown, MA 02129; Department of Psychiatry, Harvard Medical School, Center for Mindfulness and Compassion, Cambridge Health Alliance, 1035 Cambridge Street, Suite 21A, Cambridge, MA 02141., Berry MP; Department of Radiology, Harvard Medical School, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St., Charlestown, MA 02129., Napadow V; Department of Radiology, Harvard Medical School, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St., Charlestown, MA 02129., Germer C; Department of Psychiatry, Harvard Medical School, Center for Mindfulness and Compassion, Cambridge Health Alliance, 1035 Cambridge Street, Suite 21A, Cambridge, MA 02141., Pollak S; Department of Psychiatry, Harvard Medical School, Center for Mindfulness and Compassion, Cambridge Health Alliance, 1035 Cambridge Street, Suite 21A, Cambridge, MA 02141., Gardiner P; Program for Integrative Medicine and Healthcare Disparities, Boston Medical Center, Boston University School of Medicine, 771 Albany St, Boston, MA 02118., Edwards RR; Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, 850 Boylston St., Chestnut Hill, MA 02457., Desbordes G; Department of Radiology, Harvard Medical School, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th St., Charlestown, MA 02129., Schuman-Olivier Z; Department of Psychiatry, Harvard Medical School, Center for Mindfulness and Compassion, Cambridge Health Alliance, 1035 Cambridge Street, Suite 21A, Cambridge, MA 02141. Electronic address: zschuman@cha.harvard.edu.
Jazyk: angličtina
Zdroj: Psychiatry research. Neuroimaging [Psychiatry Res Neuroimaging] 2020 Oct 30; Vol. 304, pp. 111155. Date of Electronic Publication: 2020 Jul 30.
DOI: 10.1016/j.pscychresns.2020.111155
Abstrakt: Chronic pain negatively affects psychological functioning including self-perception. Self-compassion may improve self-related functioning in patients with chronic pain but understanding of the neural mechanisms is limited. In this study, twenty patients with chronic low back pain read negative self-related situations and were instructed to be either self-reassuring or self-critical while undergoing fMRI. Patients rated their feelings of self-reassurance and self-criticism during each condition, and brain responses were contrasted with neutral instructions. Trait self-compassion measures (SCS) were also acquired. Brain activations during self-criticism and self-reassurance were localized to prefrontal, self- and emotion-processing areas, such as medial prefrontal cortex, dorsolateral prefrontal cortex (dlPFC), dorsal anterior cingulate cortex and posterior cingulate cortex. Self-reassurance resulted in more widespread and stronger activations relative to self-criticism. Patients then completed a brief self-compassion training (8 contact hours, 2 weeks home practice). Exploratory pre-post comparisons in thirteen patients found that feelings of self-criticism were significantly reduced and brain activations were greater in the anterior insula and prefrontal cortical regions such as dlPFC. Pre-post increases in dlPFC activation correlated with increased self-compassion (SCS), suggesting that early self-compassion skills might primarily target self-criticism via dlPFC upregulation. Future controlled studies on self-compassion training in chronic pain populations should extend these results.
Competing Interests: Declaration of Competing Interest Jacqueline Lutz: Dr. Lutz was a postdoctoral fellow at CHA Center for Mindfulness and Compassion (CMC) within the last 3 years. CHA CMC is an academic mindfulness center, affiliated with the Harvard Medical School Department of Psychiatry, administratively within the Cambridge Health Alliance (CHA) academic community healthcare system, which is a public entity within the Cambridge Public Health Commission. Dr. Lutz's salary was not tied to the quantity or content of programs offered through CMC. Dr. Lutz has no financial conflict of interest. Michael Berry: Author has no conflicts of interest to report. Chris Germer: Dr. Christopher Germer is a lecturer in psychiatry (part-time) at Harvard Medical School/Cambridge Health Alliance (CHA). He is also on the teaching faculty of the CHA Center for Mindfulness and Compassion (CMC).  Dr. Germer is a co-developer of the Mindful Self-Compassion (MSC) training program from which this brief self-compassion intervention derived, and he is on the Board of the Center for Mindful Self-Compassion (CMSC). He does not receive a salary from CHA, CMC or CMSC, but he receives financial compensation when he teaches MSC workshops and he receives royalties from two books he co-authored about MSC. Due to his expertise, Dr. Germer was primarily responsible for designing and delivering the intervention in this study, but he did not participate in data collection, analysis, or interpretation. Susan Pollak: Dr. Susan Pollak is a teaching associate in psychiatry (part-time) at Harvard Medical School/Cambridge Health Alliance (CHA). She is on the teaching faculty of the CHA Center for Mindfulness and Compassion (CMC) and she receives financial compensation when she teaches MSC programs. Due to her expertise, Dr. Pollak collaborated with Dr. Germer co-developing and co-delivering the intervention in this study, but she did not participate in data collection, analysis, or interpretation. Paula Gardiner: Dr. Paula Gardiner is affiliated with the University of Massachusetts Medical School and Boston University Medical School. She has no financial conflict of interest. Robert Edwards: Dr. Robert Edwards is a pain psychologist and Associate Professor of Anesthesiology at Brigham & Women's Hospital, a non-profit teaching hospital affiliated with Harvard Medical School. Dr. Edwards’ salary derives from BWH and he is not compensated by CHA or its affiliates, including CMC. Author has no conflicts of interest to report. Gaelle Desbordes: Author has no conflicts of interest to report. Zev Schuman-Olivier: Dr. Schuman-Olivier is the Director of the CHA Center for Mindfulness and Compassion, which is an academic mindfulness center, affiliated with the Harvard Medical School Department of Psychiatry, administratively within the Cambridge Health Alliance (CHA) academic community healthcare system, which is a public entity within the Cambridge Public Health Commission. CMC has an educational unit that offers educational and community programs that provides mindfulness- and compassion-based program delivery to the general public for registration fees that cover the costs of the programs. Dr. Schuman-Olivier's salary is through CHA and is not tied to the quantity or content of programs offered through CMC. Dr. Schuman-Olivier has no financial conflict of interest.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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