SynthesisEuropean journal of pain (London, England)2026
Do Acceptance- and Mindfulness-Based Interventions Improve Psychological Flexibility in People With Chronic Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Synthesis in European journal of pain (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Do Acceptance- and Mindfulness-Based Interventions Improve Psychological Flexibility in People With Chronic Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.European journal of pain (London, England) · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcceptance- and mindfulness-based interventions are effective for improving pain-related outcomes, yet their effects on psychological flexibility have not been meta-analyzed. This systematic review and meta-analysis addressed this gap by comparing these interventions with control conditions on psychological flexibility and its core dimensions in adults with chronic pain.
methodsSearches were conducted in PsycINFO, MEDLINE, Cochrane CENTRAL, Scopus and Web of Science from inception to May 2025. Sixty randomized controlled trials comprising 6692 participants were included. Meta-analyses were conducted for global psychological flexibility (k = 17), acceptance (k = 38), committed action (k = 4) and values (k = 4). Heterogeneity, risk of bias and certainty of evidence were assessed.
resultsInterventions significantly improved psychological flexibility at post-treatment, short-term (≤ 6 months) and long-term (> 6 months) follow-up (g = 0.35-0.69), and acceptance across all time points (g = 0.41-0.77). Effects for committed action and values were non-significant. Heterogeneity was substantial, most trials had a high risk of bias, and the certainty of evidence was low to very low. Moderator analyses indicated larger effects when interventions were compared with inactive controls, delivered by psychologists or implemented as stand-alone programs.
conclusionsEvidence suggests that acceptance- and mindfulness-based interventions may improve global psychological flexibility and acceptance. However, the certainty of evidence was low to very low, and most included trials were at high risk of bias. More rigorous trials are needed to clarify effects across specific dimensions of psychological flexibility. SIGNIFICANCE STATEMENT: This systematic review and meta-analysis provide the first comprehensive synthesis of the effects of acceptance- and mindfulness-based interventions on psychological flexibility in chronic pain. These findings show that these interventions improve psychological flexibility, particularly pain acceptance, supporting it as a clinically relevant treatment target.
trial registrationPROSPERO: CRD420251018441.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.