Positive pain? An ICF model of character strength and chronic pain acceptance in rehabilitation

AbstractObjectivesFibromyalgia is a chronic widespread pain (CWP) syndrome of unknown etiology with substantial burden of illness and functional impairment. Pain acceptance has emerged as an interesting target of therapy in chronic pain populations, but few studies have yet been done on the effect of pain acceptance on patients with fibromyalgia. The aim of the present study was to examine the relationship between pain acceptance and its impact on function and symptoms in fibromyalgia with both a cross-sectional and longitudinal design.MethodsThree hundred and sixty five participants aged 22–70 with fibromyalgia were recruited from the Norwegian Fibromyalgia Association (NFA). They filled out a questionnaire containing the Fibromyalgia Impact Questionnaire (FIQ), measurement of function and symptoms, and Chronic Pain Acceptance Questionnaire (CPAQ), measurement of pain acceptance, in addition to sociodemographic and clinical variables such as degree of fibromyalgia, depression and pain duration (T1 measures). One year after, 87 of the participants filled out the FIQ and clinical measures once again (T2 measures). Unadjusted and adjusted linear regression analyses were performed both for cross-sectional measures at T1 and for longitudinal measures from T1 to T2, with FIQ score as the outcome variable and CPAQ score at T1 as one of the main independent variables.ResultsHigher CPAQ score was significantly associated with a lower FIQ score at T1, also when adjusting for age, education, work, depression and Fibromyalgianess Score (p<0.01). Lower FIQ score indicate less impact of fibromyalgia on functioning. In addition, two adjusted linear regression models found higher pain acceptance (CPAQ score) at T1 to be associated with lower negative impact of fibromyalgia on function and symptoms (FIQ score) at T2 (p<0.01).ConclusionsHigher pain acceptance is associated with better functional level and less symptoms in fibromyalgia, both cross-sectionally and when measurements are separated in time. Further research should include experimental studies with acceptance-based interventions for this patient group.

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Process-outcome associations in an interdisciplinary treatment for chronic pain and comorbid mental disorders based on Acceptance and Commitment Therapy

Pain Medicine ◽

10.1093/pm/pnab102 ◽

2021 ◽

Author(s):

Ludwig Ohse ◽

Ronald Burian ◽

Eric Hahn ◽

Hannah Burian ◽

Thi Minh Tam Ta ◽

...

Keyword(s):

Chronic Pain ◽

Mental Disorders ◽

Clinical Outcomes ◽

Acceptance And Commitment Therapy ◽

Psychological Flexibility ◽

Post Treatment ◽

Interdisciplinary Treatment ◽

Pain Acceptance ◽

Acceptance And Commitment ◽

Comorbid Mental Disorders

Abstract Objective Numerous studies support the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain, yet little research has been conducted about its underlying mechanisms of change, especially regarding patients with comorbid mental disorders. The present investigation addressed this issue by examining associations of processes targeted by ACT (pain acceptance, mindfulness, psychological flexibility) and clinical outcomes (pain intensity, somatic symptoms, physical health, mental health, depression, general anxiety). Subjects Participants were 109 patients who attended an ACT-based interdisciplinary treatment program for chronic pain and comorbid mental disorders in a routine care psychiatric day hospital. Methods Pre- to post-treatment differences in processes and outcomes were examined with Wilcoxon signed-rank tests and effect size r. Associations between changes in processes and changes in outcomes were analyzed with correlation and multiple regression analyses. Results Pre- to post-treatment effect sizes were mostly moderate to large (r between |0.21| and |0.62|). Associations between changes in processes and changes in outcomes were moderate to large for both, bivariate correlations (r between |0.30| and |0.54|) and shared variances accounting for all three processes combined (R2 between 0.21 and 0.29). Conclusion The present investigation suggests that changes in pain acceptance, mindfulness and psychological flexibility are meaningfully associated with changes in clinical outcomes. It provides evidence on particular process-outcome associations that had not been investigated in this way before. The focus on comorbid mental disorders informs clinicians about a population of chronic pain patients that often has a severe course of illness and has seldom been studied.

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The Relationship Between Lifestyle with Chronic Pain and Pain Acceptance in Elderly with Stroke

Archives of Neuroscience ◽

10.5812/ans.83717 ◽

2018 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Masoud Hatefi ◽

Asma Tarjoman ◽

Milad Borji

Keyword(s):

Chronic Pain ◽

Pain Acceptance ◽

The Relationship

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Pain Resilience: Issues of Modeling Dynamic Adaptation in Chronic Pain

Escritos de Psicología / Psychological Writings ◽

10.24310/espsiescpsi.v9i3.13213 ◽

2016 ◽

Vol 9 (3) ◽

pp. 15-27

Author(s):

John A. Sturgeon ◽

Chloe J. Taub

Keyword(s):

Chronic Pain ◽

Empirical Evidence ◽

Dynamic Process ◽

Individual Characteristics ◽

Dynamic Adaptation ◽

Psychological Interventions ◽

Affective States ◽

Pain Acceptance ◽

Empirical Inquiry ◽

Pain Adaptation

In recent years, there has been increasing interest in processes and characteristics that may underlie resilient adaptation to chronic pain. With this recent increase in empirical inquiry, there has emerged a degree of ambiguity in terms between pain resilience and other constructs previously connected to effective pain adaptation, such as pain acceptance, psychological flexibility, and pain self-efficacy. Objectives of the current paper included reviewing recent clinical and empirical evidence in the area of chronic pain resilience and offering a synthesis of these findings, with a specific focus on issues of defining and operationalizing this construct, compared to other constructs relevant to pain adaptation. We conclude that resilience is best defined as a dynamic process related to both stable individual characteristics and contextual and state factors, such as goal contexts and affective states. Finally, the implications of this model are discussed in the context of the extant literature on psychological interventions for chronic pain.

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The Chronic Pain Acceptance Questionnaire: Confirmatory factor analysis and identification of patient subgroups

Pain ◽

10.1016/j.pain.2008.08.012 ◽

2008 ◽

Vol 140 (2) ◽

pp. 284-291 ◽

Cited By ~ 125

Author(s):

Kevin E. Vowles ◽

Lance M. McCracken ◽

Charlotte McLeod ◽

Christopher Eccleston

Keyword(s):

Chronic Pain ◽

Factor Analysis ◽

Confirmatory Factor Analysis ◽

Pain Acceptance ◽

Confirmatory Factor ◽

Patient Subgroups

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Chronic Pain Acceptance Questionnaire--Adolescent Version

PsycTESTS Dataset ◽

10.1037/t78343-000 ◽

2010 ◽

Author(s):

Lance M. McCracken ◽

Jeremy Gauntlett-Gilbert ◽

Christopher Eccleston

Keyword(s):

Chronic Pain ◽

Pain Acceptance

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Chronic Pain Acceptance Questionnaire--Parent Report

PsycTESTS Dataset ◽

10.1037/t12131-000 ◽

2011 ◽

Author(s):

Laura E. Simons ◽

Christine B. Sieberg ◽

Karen J. Kaczynski

Keyword(s):

Chronic Pain ◽

Parent Report ◽

Pain Acceptance

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Support for the Spanish version of the CPAQ‐8 as a measure of chronic pain acceptance

Journal of Evaluation in Clinical Practice ◽

10.1111/jep.13092 ◽

2018 ◽

Vol 25 (5) ◽

pp. 881-888 ◽

Cited By ~ 2

Author(s):

Elisabet Sánchez‐Rodríguez ◽

Rocío Vega ◽

Mélanie Racine ◽

Rubén Roy ◽

Mark P. Jensen ◽

...

Keyword(s):

Chronic Pain ◽

Spanish Version ◽

Pain Acceptance

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MECHANISM OF ACTION: AGE DIFFERENCES IN RESPONSE TO ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN

Innovation in Aging ◽

10.1093/geroni/igz038.2979 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S809-S809

Author(s):

Julie L Wetherell ◽

Matthew Herbert ◽

Niloofar Afari

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Acceptance And Commitment Therapy ◽

Behavioral Therapy ◽

Pain Interference ◽

Younger Adults ◽

Pain Acceptance ◽

Commitment Therapy ◽

Acceptance And Commitment

Abstract A recent randomized comparison of Acceptance and Commitment Therapy (ACT) vs. Cognitive-Behavioral Therapy for chronic pain found a clear age interaction effect, such that older adults benefitted more from ACT. In a subsequent study comparing ACT delivered in person to ACT delivered via telehealth to a sample of veterans (N=128, mean age 51.9, SD 13.3, range 25-89), we found no significant age by modality interactions, suggesting that older veterans responded as well as younger people did to telehealth delivery. Consistent with our previous findings, we found a trend for older adults to experience greater reduction in pain interference (p = .051) and significantly greater reduction in pain severity (p = .001) than younger adults following ACT. In younger veterans, change in pain acceptance from baseline to posttreatment was related to change in pain interference from baseline to 6-month follow-up (r = -.38), but change in pain interference from baseline to posttreatment was not related to change in pain acceptance from baseline to follow-up (r = .14), suggesting that, consistent with the ACT model, increased pain acceptance at posttreatment was related to reduced pain interference at follow-up. By contrast, in older veterans, both correlations were significant and of comparable magnitude (rs = -.43 and -.46, respectively), providing no support for the idea that change in pain acceptance drove change in pain interference. Overall, our findings suggest that ACT may work better in older adults with chronic pain than in younger adults, but via a different mechanism.

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