Trait mindfulness and catastrophizing as mediators of the association between pain severity and pain-related impairment

• The three-path mediation model of pain-related impairment was not significant.
• Mindfulness mediated the relation between pain severity and pain catastrophizing.
• The pain severity-pain-related impairment association was mediated by mindfulness.
• Pain catastrophizing was not a significant predictor of pain-related impairment.

The present study examined dispositional mindfulness and pain catastrophizing as mediators of the relation between pain severity and pain-related impairment controlling for pain acceptance in a group of college students classified as either low (N = 177) or high (N = 158) in pain severity. We tested a three-path model of the following sequence: pain severity → trait mindfulness → pain catastrophizing → pain-related impairment. Structural equation modeling indicated good fit of the proposed model to the data. Mediational analyses with percentile bootstrapping revealed that mindfulness mediated the relations between pain severity and (a) catastrophizing; and (b) pain-related impairment. Unexpectedly, after controlling for mindfulness and pain acceptance, catastrophizing was not significantly associated with pain-related impairment. Several explanations are provided for the null effect of pain catastrophizing on pain-related impairment. Finally, future research directions are discussed.