Skip to main content
SpringerLink
Log in

Validation of the Chronic Pain Acceptance Questionnaire-8 in an Australian Pain Clinic Sample

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Recently, an 8-item short-form version of the Chronic Pain Acceptance Questionnaire (CPAQ-8) was developed predominantly in an internet sample. Further investigation of the factor structure in a multidisciplinary pain clinic sample is required. Investigation of the concurrent validity of the CPAQ-8 after accounting for the effects of variables commonly measured in the pain clinic setting is also necessary.

Purpose

This study examines the factor structure and concurrent validity of the CPAQ-8 in a sample of treatment-seeking patients who attended a multidisciplinary pain clinic.

Methods

Participants were 334 patients who attended an Australian multidisciplinary pain service. Participants completed the CPAQ, a demographic questionnaire, and measures of patient adjustment and functioning.

Results

Confirmatory factor analysis identified a two-factor 8-item model consisting of Activity Engagement and Pain Willingness factors (SRMR = 0.039, RMSEA = 0.063, CFI = 0.973, TLI = 0.960) was superior to both the CPAQ and CPAQ with an item removed. The CPAQ and CPAQ-8 total scores were highly correlated (r = 0.93). After accounting for pain intensity, the CPAQ-8 was a significant predictor of depression, anxiety, stress, and disability. The subscales of the CPAQ-8 were both unique contributors to depression and disability in regression analyses, after accounting for pain intensity and kinesiophobia, and after accounting for pain intensity and catastrophizing.

Conclusions

The CPAQ-8 has a sound factor structure and similar psychometric properties to the CPAQ; it may have clinical utility as a measure of pain acceptance in treatment-seeking, chronic pain patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. McCracken LM, Vowles KE, Eccleston C. Acceptance of chronic pain: component analysis and a revised assessment method. Pain. 2004;197:159–66.

    Article  Google Scholar 

  2. McCracken LM. Toward understanding acceptance and psychological flexibility in chronic pain. Pain. 2010;149:420–1.

    Article  PubMed  Google Scholar 

  3. Reneman M, Dijkstra A, Geertzen J, Dijkstra P. Psychometric properties of chronic pain acceptance questionnaires: a systematic review. European J Pain. 2010;14:457–65.

    Article  Google Scholar 

  4. Nicholas MK, Asghari A. Investigating acceptance in adjustment to chronic pain: is acceptance broader than we thought? Pain. 2006;124:269–79.

    Article  PubMed  Google Scholar 

  5. Wicksell RK, Olsson GL, Melin L. The Chronic Pain Acceptance Questionnaire (CPAQ)—further validation including a confirmatory factor analysis and a comparison with the Tampa Scale of Kinesiophobia. European J Pain. 2009;13:760–8.

    Article  Google Scholar 

  6. Geisser DS. A comparison of acceptance-focused and control-focused psychological treatments in a chronic pain treatment center (Unpublished Doctoral Dissertation). Reno, NV:University of Nevada; 1992

  7. McCracken LM. Behavioral constituents of chronic pain acceptance: results from factor analysis of the chronic pain acceptance questionnaire. J Back Musculos Rehab. 1999;13:93–100.

    Google Scholar 

  8. Vowles KE, McCracken LM, McLeod C, Eccleston C. The Chronic Pain Acceptance Questionnaire: confirmatory factor analysis and identification of patient subgroups. Pain. 2008;140:284–91.

    Article  PubMed  Google Scholar 

  9. Fish R, McGuire B, Hogan M, Morrison T, Stewart I. Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-8. Pain. 2010;149:435–43.

    Article  PubMed  Google Scholar 

  10. Vlaeyen JWS, Linton SJ. Fear-avoidance model of chronic musculoskeletal pain: 12 years on. Pain. 2012;153:1144–7.

    Article  PubMed  Google Scholar 

  11. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity scales. Pain. 2011;152:2399–404.

    Article  PubMed  Google Scholar 

  12. Flor H, Behle DJ, Birbaumer N. Assessment of pain-related cognitions in chronic pain patients. Behav Res Therapy. 1993;31:63–73.

    Article  CAS  Google Scholar 

  13. Kori SH, Miller RP, Todd DD. Kinesiophobia: a new view of chronic pain behavior. Pain Management, 35–43, 1990.

  14. Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62:363–72.

    Article  CAS  PubMed  Google Scholar 

  15. Rolland M, Morris S. A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine. 1983;8:141–4.

    Article  Google Scholar 

  16. Asghari A, Nicholas MK. Pain self-efficacy beliefs and pain behaviour. A prospective study. Pain. 2001;94:85–100.

    Article  CAS  PubMed  Google Scholar 

  17. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behav Res Therapy. 1995;33:335–43.

    Article  CAS  Google Scholar 

  18. Nicholas MK, Asghari A, Blyth FM. What do the numbers mean? Normative data in chronic pain measures. Pain. 2008;134:158–73.

    Article  PubMed  Google Scholar 

  19. Taylor R, Lovibond PF, Nicolas MK, Cayley C, Wilson PH. The utility of somatic items in the assessment of depression in chronic pain patients: a comparison of the Zung Self-Rating Depression Scale (SDS) and the Depression Anxiety Stress Scale (DASS) in chronic pain and clinical and community samples. Clinical J Pain. 2005;21:91–100.

    Article  Google Scholar 

  20. Browne MW, Cudeck R. Alternative Ways of Assessing Model Fit. In: Bollen KA, Long JSS, editors. Testing structural equation models. London: Sage; 1993.

    Google Scholar 

  21. Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6:1–55.

    Article  Google Scholar 

  22. DeCarlo LT. On the meaning and use of kurtosis. Psychol Methods. 1997;2:292–307.

    Article  Google Scholar 

  23. McCracken LM. Learning to live with pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain. 1998;74:21–7.

    Article  CAS  PubMed  Google Scholar 

  24. McCracken LM. Toward understanding acceptance and psychological flexibility in chronic pain. Pain. 2010;149:420–1.

    Article  PubMed  Google Scholar 

  25. DiStefano C, Motl RW. Further investigating method effects associated with negatively worded items on self-report surveys. Struct Equ Model. 2006;13:440–64.

    Article  Google Scholar 

  26. Schmitt N, Stults DM. Factors defined by negatively keyed items: the result of careless respondents? Appl Psychol Measures. 1985;9:367–73.

    Article  Google Scholar 

Download references

Disclosures

No authors have any potential conflicts of interest. Preparation of this paper was supported in part by a National Health and Medical Research Council of Australia Career Development Fellowship held by Jason Connor (1031909).

Author information

Authors and Affiliations

  1. School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia

    John Baranoff & Stephanie J. Hanrahan

  2. School of Human Movement Studies, The University of Queensland, Brisbane, Australia

    Stephanie J. Hanrahan

  3. Pain Management Unit, Flinders Medical Centre, Bedford Park, Adelaide, Australia

    Dilip Kapur

  4. Discipline of Psychiatry, The University of Queensland, Brisbane, Australia

    Jason P. Connor

  5. Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia

    Jason P. Connor

Authors
  1. John Baranoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephanie J. Hanrahan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dilip Kapur
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jason P. Connor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John Baranoff.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baranoff, J., Hanrahan, S.J., Kapur, D. et al. Validation of the Chronic Pain Acceptance Questionnaire-8 in an Australian Pain Clinic Sample. Int.J. Behav. Med. 21, 177–185 (2014). https://doi.org/10.1007/s12529-012-9278-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-012-9278-6

Keywords

Search

Navigation