(501) Examining committed action in chronic pain: further validation and clinical utility of the committed action questionnaire

Abstract

Psychosocial treatments for chronic pain conditions, such as Acceptance and Commitment Therapy (ACT), have highlighted minimizing pain avoidance behaviors and increasing engagement in valued activities as key treatment targets. In terms of salient processes within ACT, committed action is considered essential to the pursuit of a meaningful life, as it entails a flexible persistence over time in living consistently with one's values. To date, however, only one study has examined the association between measures of committed action and important aspects of pain-related functioning. The purpose of the present study was to analyze the reliability of the Committed Action Questionnaire (CAQ) in a sample of 149 chronic pain patients, perform a confirmatory analysis of its factor structure, and examine how CAQ scores uniquely account for variance in functioning. Confirmatory factor analyses provided support for a two-factor model, and regression analyses, which examined the cross-sectional direct effects of the two subscales on health-related functioning, indicated that the CAQ accounted for significant variance in functioning after controlling for relevant covariates. Overall, these findings provide further support for the CAQ as a measure of adaptive functioning in those with longstanding pain. Highlights: Examined the utility of the committed action questionnaire in chronic pain patients  149 pain patients were included in the analyses  Results of the analyses showed support for the two-factor model  Committed action scores were significantly associated with psychosocial functioning Highlights Response to ReviewersExamining Committed Action in Chronic Pain:Further Validation and Clinical Utility of the Committed Action Questionnaire Resubmitted to The Journal of PainMay 12, 2016Reviewer 11. Notes that the sample size is small for a CFA, given the recommended ratio of cases to model parameters is 10:1.We agree with this point and listed this issue in the discussion section as one of the primary limitations of the study.2. Provides a suggestion for future research to change the valence of the second subscale so as to rule out the possibility of wording effects contributing to the two-factor solution.Although this seemed to be more of a general suggestion rather than a request for a specific revision, we appreciated this feedback and decided to integrate this comment into the discussion section on limitations and future directions. [pg. 23] Reviewer 21. The reviewer states that "valued living" may be too imprecise and that "values-based or values-guided action" is more consistent with the ACT philosophy.This comment appeared related to this reviewer's comment in point 4 and compelled us to return to Hayes, Strosahl and Wilson (2012). We have made the requested changes in order to help ensure the language we are using is consistent with the behavioral underpinnings of ACT. [pg. 2] 2. The reviewer objects to the reference made to altering behavior as the primary goal of treatment on the grounds that no...