The effect of Mindfulness-Based Stress Reduction on pain and disease activity with people who have Rheumatoid Arthritis: Mechanisms of action

INTERVENTION: Mindfulness‐Based Stress Reduction (MBSR) is an 8‐week intervention which involves training in mindfulness meditation, a practice of self‐regulating attention in a present‐moment‐oriented, non‐judgmental manner, that lowers reactivity to stress triggers. Participants are required to attend a weekly two‐hour training session, a one‐day retreat (mid‐intervention) and complete daily homework in the form of mindfulness exercises. During the course, participants will learn formal mindfulness practices of sitting meditation, walking meditation, and mindful yoga and how to integrate practice into everyday life. Training sessions will be administered in group classes (10 people per group) by the PhD candidate who is trained in teaching MBSR. CONDITION: Rheumatoid Arthritis PRIMARY OUTCOME: Pain as measured by visual analogue, pain‐related acceptance as measured by the Chronic Pain Acceptance Questionnaire (McCracken et al, 2004) and disease activity as assessed by the Disease Activity Score in 28 joints (DAS28‐CRP), a composite measure reflecting the number of tender and swollen joints, C‐reactive Protein and patients' assessment of general health on a 100‐mm visual analogue scale. SECONDARY OUTCOME: Depression/anxiety as measured by the Hospital and Anxiety Scale (Zigmond & Snaith, 2007) and psychological well‐being (Ryff & Keyes, 1995). INCLUSION CRITERIA: 18 years of age, English fluency, diagnosis of Rheumatoid Arthritis according to criteria of the American College of Rheumatology