A Comprehensive Examination of the Model Underlying Acceptance and Commitment Therapy for Chronic Pain
Section snippets
Participants
All participants attended an assessment appointment within an interdisciplinary pain rehabilitation service located in Staffordshire, UK. In total, data were collected from 274 of the 292 (93.8%) consecutive patients seen by the service over a 30-month period. Participant age averaged 51.7 years (SD = 14.8). The majority were female (71.9%) and White European (96.1%). Most were married or cohabitating (63.8%; divorced, 13.1%; single, 14.1%; widowed, 8.6%). Participants averaged 12.8 years of formal
Data Integrity
The left-sided panels of Table 1, Table 2 provide descriptive information for all study measures. Internal consistency ratings (Cronbach’s α) for all measures were above 0.77 (range: 0.77 – 0.92). Evaluation of data distributions indicated that the majority of variables were normally distributed and non-kurtotic. The only exception was for the variable assessing highest pain in the past week, for which there was evidence of significant kurtosis (value = 2.43). Essentially, and as would be
Discussion
The primary purpose of the present analyses was to examine the ACT model, as represented by measures of the identified processes of psychological flexibility, in relation to specific aspects of functioning in individuals with chronic pain. A number of preliminary statistical analyses were performed to help inform a structure for the final model, the fit of which was ultimately examined via SEM. Fit of this final model to the data was acceptable, as the ACT processes both correlated with one
Conflict of Interest Statement
The authors have no conflicts of interest to declare.
References (51)
- et al.
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) - et al.
Using session-by-session measurement to compare mechanisms of action for Acceptance and Commitment Therapy and Cognitive Therapy
Behavior Therapy
(2012) - et al.
Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain
Journal of Pain
(2006) - et al.
The development of a battery of measures for assessing physical functioning of chronic pain patients
Pain
(1994) - et al.
Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy
Behavior Therapy
(2013) - et al.
Comparative reliability and validity of chronic pain intensity measures
Pain
(1999) Social context and acceptance of chronic pain: The role of solicitous and punishing respnses
Pain
(2005)- et al.
The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability
Pain
(2007) - et al.
Psychological flexibility and traditional pain management strategies in relation to patient functioning with chronic pain: an examination of a revised instrument
Journal of Pain
(2007) - et al.
Acceptance of chronic pain: component analysis and a revised assessment method
Pain
(2004)
The role of values in a contextual cognitive-behavioral approach to chronic pain
Pain
General psychological acceptance and chronic pain: There is more to accept than the pain itself
European Journal of Pain
An examination of self-compassion in relation to positive psychological functioning and personality traits
Journal of Research in Personality
Identifying important outcome domains for chronic pain clinical trials: An IMMPACT survey of people with pain
Pain
Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis
Pain
Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes
Behaviour Research and Therapy
The Chronic Pain Acceptance Questionnaire: Confirmatory factor analysis and identification of patient subgroups
Pain
Acceptance and values-based action in chronic pain: a three-year follow-up analysis of treatment effectiveness and process
Behaviour Research and Therapy
Acceptance and Commitment Therapy for chronic pain: Evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation
Journal of Pain
Adolescent acceptance of pain: Confirmatory factor analysis and further validation of the Chronic Pain Acceptance Questionnaire, adolescent version
Journal of Pain
The Psychological Inflexibility in Pain Scale (PIPS)—Statistical properties and model fit of an instrument to assess change processes in pain related disability
European Jounal of Pain
The Chronic Pain Acceptance Questionnaire (CPAQ)-further validation including a confirmatory factor analysis and a comparison with the Tampa Scale of Kinesiophobia
European Journal of Pain
Missing Data
The Sickness Impact Profile: Development and final revision of a health status measure
Medical Care
Structural equation modeling with AMOS: Basic concepts, applications, and programming
Cited by (78)
A Network Analysis Approach on the Psychological Flexibility/Inflexibility Model
2023, Behavior TherapyThe role of the acceptance and commitment therapy in the treatment of social anxiety: An updated scoping review
2022, Journal of Affective DisordersCitation Excerpt :Additionally, from the results it emerged that the ACT treatment effectively reduced the feelings of shame that affect experiential avoidance (Etzel, 2006), which is one of the criteria of psychological inflexibility in the ACT, by reducing fear and concern about public situations and negative judgments. Interestingly, the improvement was also observed in self-compassion, which, although it is not a target variable of the ACT, could be a powerful mediator of the effectiveness of this treatment (Vowles et al., 2014). Overall, these results point towards the hypothesis that ACT, similar to the traditional CBT, leads to a decrease in discomfort related to socially anxious thoughts.
Embracing complex models: Exploratory network analyses of psychological (In)Flexibility processes and unique associations with psychiatric symptomology and quality of life
2022, Journal of Contextual Behavioral ScienceEfficacy of Online-Based Acceptance and Commitment Therapy for Chronic Pain: A Systematic Review and Meta-Analysis
2021, Journal of PainCitation Excerpt :Meta-analytical evidence on the efficacy of compassion-focused therapies, aiming to promote self-compassion, a known antidote to self-criticism34, have presented considerably higher effect sizes on depression (d = 0.64)25. It may thus be argued that ACT's effect on depression would benefit from the inclusion of complementary self-compassion components58,59. The overall quality of each of the selected trials was evaluated as “some concerns of performance bias” as assessed by the Cochrane assessment of bias tool46, mostly due to the impossibility to blind participants of their allocation.