Olivia BERNINI*1, Teresa RIVAS2, Carmen BERROCAL1
1 Department of Surgical, Medical, Molecular, and Critical Area Pathology, University of Pisa, Italy
2 Department of Psychology, University of Málaga, Spain
This study explored whether Activity Engagement (AE) and Pain Willingness (PW) – as measured by the Chronic Pain Acceptance Questionnaire (CPAQ) – are useful to identify, beyond potential confounders, significant subgroups of patients with chronic pain. We also explored the validity of AE and PW processes, as well as the interaction between them, to longitudinally predict adjustment. A total of 133 patients with chronic pain participated in the study at Time 1 (T1), and 32 patients returned 12 months later (T2) for assessment. The participants completed at T1 and T2 the CPAQ and measures of depression, anxiety, pain-related anxiety, psychological well-being (PWB), and disability. In line with previous research, cluster analyses revealed three subgroups of patients on the basis of CPAQ scores, which significantly differed one other on adjustment, even when potential confounders were controlled. Furthermore, lower AE scores at T1 significantly predicted lower PWB and higher disability and pain-related anxiety at T2, beyond outcome measures at T1. Relations of disengagement with poorer PWB and disability were stronger when PW was low at T1. The findings support the predictive validity of the CPAQ and provide further evidence supporting the benefits of AE and PW (as a whole) on pain adjustment.
Keywords: pain willingness, activity engagement, psychological flexibility, chronic pain, Acceptance and Commitment Therapy