Adolescent acceptance of pain: confirmatory factor analysis and further validation of the chronic pain acceptance questionnaire, adolescent version

Dustin P Wallace, Cynthia Harbeck-Weber, Stephen P H Whiteside, Tracy E Harrison
Journal of Pain 2011, 12 (5): 591-9

UNLABELLED: Preliminary reports suggest that acceptance of pain is an important construct when assessing and treating adolescents with chronic pain. Although the Chronic Pain Acceptance Questionnaire, Adolescent version (CPAQ-A) appears to be a promising tool, it has been evaluated in only 1 study. The current results present a confirmatory analysis of the CPAQ-A and validity data collected independently from the developers of the scale. A sample of 109 adolescents with chronic pain completed the CPAQ-A, as well as measures of pain characteristics, functional impairment, depression, anxiety, and pain self-efficacy. Results of the confirmatory factor analysis indicate the previously reported 2-factor solution provides a good fit to the data, and has acceptable internal consistency. The CPAQ-A correlated strongly with disability, depression, anxiety, and self-efficacy. It correlated only moderately with pain intensity and was not correlated with pain frequency or duration of pain. When entered last into a hierarchical regression model predicting disability, acceptance accounted for more variance than pain intensity, depression, anxiety, and self-efficacy. Results supported the internal consistency and validity of the CPAQ-A as a measure of pain acceptance in this sample of adolescents with chronic pain. Use of the CPAQ-A may provide valuable insight into the manner in which adolescents adapt to chronic pain and can guide acceptance-based treatment.

PERSPECTIVE: This article strengthens the psychometric support for a measure of chronic pain acceptance in adolescents. Acceptance-based treatment has been shown to reduce disability in preliminary research targeting adolescents with chronic pain; the CPAQ-A may be useful for assessing the degree to which acceptance-based approaches may be indicated for a given patient.

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