Abstract
Preliminary reports suggest that acceptance of pain is an important construct when
assessing and treating adolescents with chronic pain. Although the Chronic Pain Acceptance
Questionnaire, Adolescent version (CPAQ-A) appears to be a promising tool, it has
been evaluated in only 1 study. The current results present a confirmatory analysis
of the CPAQ-A and validity data collected independently from the developers of the
scale. A sample of 109 adolescents with chronic pain completed the CPAQ-A, as well
as measures of pain characteristics, functional impairment, depression, anxiety, and
pain self-efficacy. Results of the confirmatory factor analysis indicate the previously
reported 2-factor solution provides a good fit to the data, and has acceptable internal
consistency. The CPAQ-A correlated strongly with disability, depression, anxiety,
and self-efficacy. It correlated only moderately with pain intensity and was not correlated
with pain frequency or duration of pain. When entered last into a hierarchical regression
model predicting disability, acceptance accounted for more variance than pain intensity,
depression, anxiety, and self-efficacy. Results supported the internal consistency
and validity of the CPAQ-A as a measure of pain acceptance in this sample of adolescents
with chronic pain. Use of the CPAQ-A may provide valuable insight into the manner
in which adolescents adapt to chronic pain and can guide acceptance-based treatment.
Perspective
This article strengthens the psychometric support for a measure of chronic pain acceptance
in adolescents. Acceptance-based treatment has been shown to reduce disability in
preliminary research targeting adolescents with chronic pain; the CPAQ-A may be useful
for assessing the degree to which acceptance-based approaches may be indicated for
a given patient.
Key words
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References
- Chronic tension-type headache in adolescents. Clinical and psychological characteristics analyzed through self- and parent-report questionnaires.J Pediatr Psychol. 2009; 34: 697-706
- Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions).Pain. 2006; 125: 35-42
- Structural equation modeling with AMOS: Basic concepts, applications, and programming, 1st ed.Lawrence Erlbaum Associates, Mahwah, NJ2001
- Functional assessment of pediatric pain patients: Psychometric properties of the Functional Disability Inventory.Pain. 2006; 121: 77-84
- Acceptance and commitment therapy for chronic pain, 1st ed.Context Press, Reno, NV2005
- Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial.Behav Ther. 2004; 35: 785-801
- An assessment of the relative influence of pain coping, negative thoughts about pain, and pain acceptance on health-related quality of life among people with hemophilia.Pain. 2009; 145: 169-275
- The need for a new medical model: A challenge for biomedicine.Science. 1977; 196: 129-136
- Effects of sample size, estimation methods, and model specification on structural equation modeling fit indexes.Struct Equ Modeling. 1999; 6: 56-83
- Psychosocial impact of headache and comorbidity with other pains among Swedish school adolescents.Headache. 2002; 42: 766-775
- Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-8.Pain. 2010; 149: 420-421
- The CES-D as a screen for depression and other psychiatric disorders in adolescents.J Am Acad Child Adolesc Psychiatry. 1991; 30: 636-641
- The biopsychosocial approach to chronic pain: Scientific advances and future directions.Psychol Bull. 2007; 133: 581-624
- Disability in adolescents with chronic pain: Patterns and predictors across different domains of functioning.Pain. 2007; 131: 132-141
- A comparison of acceptance-focused and control-focused psychological treatments in a chronic pain treatment center [abstract].Diss Abstr Int 54(2-B). 1993;
- The epidemiology of pain in children and adolescents: A review.Pain. 1991; 46: 247-264
- Acceptance and commitment therapy and traditional cognitive behavior therapy approaches to pain.Cogn Behav Pract. 2006; 13: 185-187
- Depression and functional disability in chronic pediatric pain.Clin J Pain. 2001; 17: 341-349
- Psychological aspects of persistent pain: Current state of the science.J Pain. 2004; 5: 195-211
- The association of pain and depression in preadolescent girls: Moderation by race and pubertal stage.J Pediatr Psychol. 2009; 34: 727-737
- Principles and Practice of Structural Equation Modeling.2nd ed. Guilford Press, New York, NY2005
- Age-dependent relationships among pain, depressive symptoms, and functional disability in youth with recurrent headaches.Headache. 2006; 46: 656-662
- Coping or acceptance: What to do about chronic pain?.Pain. 2003; 105: 197-204
- A prospective study of acceptance of pain and patient functioning with chronic pain.Pain. 2005; 118: 164-169
- Acceptance of pain in adolescents with chronic pain: Validation of an adapted assessment instrument and preliminary correlation analyses.Eur J Pain. 2010; 14: 316-320
- Contextual cognitive-behavioral therapy for severely disabled chronic pain sufferers: Effectiveness and clinically significant change.Eur J Pain. 2007; 11: 314-322
- Acceptance of chronic pain: Component analysis and a revised assessment method.Pain. 2004; 107: 159-166
- Acceptance-based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase.Behav Res Ther. 2005; 43: 1335-1346
- Three traditional and three new childhood anxiety questionnaires: Their reliability and validity in a normal adolescent sample.Behav Res Ther. 2002; 40: 753-772
- Correlations among two self-report questionnaires for measuring DSM-defined anxiety disorder symptoms in children: The Screen for Child Anxiety Related Emotional Disorders and the Spence Children’s Anxiety Scale.Pers Individ Dif. 2000; 28: 333-346
- The pain self-efficacy questionnaire: Taking pain into account.Eur J Pain. 2007; 11: 153-163
- Investigating acceptance in adjustment to chronic pain: Is acceptance broader than we thought?.Pain. 2006; 124: 269-279
- Impact of recurrent and chronic pain on child and family daily functioning: A critical review of the literature.J Dev Behav Pediatr. 2000; 21: 58-69
- The Center for Epidemiologic Studies Depression Scale with a young adolescent population: A confirmatory factor analysis.Multivariate Behav Res. 2006; 41: 147-163
- Quality of life in childhood migraines: Clinical impact and comparison to other chronic illnesses.Pediatr. 2003; 112: e1-e5
- The CES-D Scale: A self-report depression scale for research in the general population.Appl Psychol Meas. 1977; 1: 385-401
- Primary juvenile fibromyalgia: Psychological adjustment, family functioning, coping, and functional disability.Arthritis Rheum. 1997; 40: 752-760
- Pain among children and adolescents: Restrictions in daily living and triggering factors.Pediatr. 2005; 115: e152-e162
- A measure of anxiety symptoms among children.Behav Res Ther. 1998; 36: 545-566
- Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes.Behav Res Ther. 2010; 48: 141-146
- Processes of change in treatment for chronic pain: The contributions of pain, acceptance, and catastrophizing.Eur J Pain. 2007; 11: 779-787
- The Chronic Pain Acceptance Questionnaire: Confirmatory factor analysis and identification of patient subgroups.Pain. 2008; 140: 284-291
- The Functional Disability Inventory: Measuring a neglected dimension of child health status.J Pediatr Psychol. 1991; 16: 39-58
- Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial.Cogn Behav Ther. 2008; 37: 169-182
- Using acceptance and commitment therapy in the rehabilitation of an adolescent female with chronic pain: A case example.Cogn Behav Pract. 2005; 12: 267-274
- Acceptance and commitment therapy for pediatric chronic pain.in: Greco L.A. Hayes S.C. Acceptance and Mindfulness Treatments for Children and Adolescents: A Practitioner’s Guide, 1st ed. New Harbinger Publications, Oakland, CA2008: 89-113
- Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain–a randomized controlled trial.Pain. 2009; 141: 248-257
- Exposure and acceptance in the rehabilitation of adolescents with idiopathic chronic pain–a pilot study.Eur J Pain. 2007; 11: 267-274
- The Chronic Pain Acceptance Questionnaire (CPAQ): Further validation including a confirmatory factor analysis and a comparison with the Tampa Scale of Kinesiophobia.Eur J Pain. 2009; 13: 760-768
Article info
Publication history
Published online: March 23, 2011
Accepted:
November 15,
2010
Received in revised form:
October 29,
2010
Received:
August 20,
2010
Footnotes
The authors have no potential conflicts of interest to disclose.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
