Acceptance of pain in adolescents with chronic pain: validation of an adapted assessment instrument and preliminary correlation analyses

Abstract

It is important to understand the processes that contribute to disability and distress in adolescents with chronic pain. For example, research has identified that when adolescents can positively adapt to the consequences of health condition, rather than attempt to change the condition itself, they also function better and experience less distress. This pattern of behavior is similar to what is referred to as "acceptance" of pain in the adult literature. Although acceptance is consistently associated with positive outcomes in adult studies, there has been less investigation of acceptance in adolescents. This study aimed to examine the reliability and validity of an adolescent-adapted version of the Chronic Pain Acceptance Questionnaire (CPAQ-A), and, using this instrument, to carry out a preliminary investigation of acceptance in adolescents with chronic pain. A sample of 122 highly disabled adolescents with chronic pain attending a specialty service completed the adapted CPAQ-A. They also completed standardized measures of their pain and daily functioning. Results supported the reliability and validity of the CPAQ-A. Correlation analyses showed that higher levels of acceptance were associated with lower levels of distress and disability, but not with lower pain intensity. Regression analyses were carried out to assess the independent contribution of acceptance after pain intensity and demographic variables were taken into account. In these analyses acceptance accounted for significant variance in disability, psychological distress, and developmental and family functioning. We discuss developmental aspects of acceptance in adolescents and clinical implications of these findings.