Behavioral constituents of chronic pain acceptance: Results from factor analysis of the Chronic Pain Acceptance Questionnaire

Clinical experience and research show that patients with chronic pain who have a more accepting attitude about their pain experience less distress and function better as compared to those with chronic pain who do not have this attitude. Because this idea has only recently received some empirical scrutiny, the meaning of acceptance and methods for assessing it in relation to chronic pain have not been firmly established. The purpose of this study was to investigate the behavioral components underlying acceptance of chronic pain. Responses to the Chronic Pain Acceptance Questionnaire from 230 persons seeking treatment for chronic pain were submitted for principal components analysis with oblique rotation. Based on percent variance, interpretability, and the scree test, four factors were extracted, accounting for 53% of total variance in 27 items. Factors included (1) engaging in normal life activities, (2) believing that controlling thoughts controls pain, (3) recognizing that pain may not change, and (4) needing to avoid or control pain. Based on analysis of item summary scores, Factor 2, the "cognitive control" factor, showed the smallest corrected factor-total correlation, suggesting that it may not be an important facet of acceptance. Studies of acceptance of pain have shown that it has potentially high utility for understanding the process of adjustment to chronic pain, however, continued study of this complex attitude is needed.