The Chronic Pain Acceptance Questionnaire (CPAQ)‐further validation including a confirmatory factor analysis and a comparison with the Tampa Scale of Kinesiophobia

Abstract

Acceptance of pain and distress has lately appeared as an important factor in determining peoples' ability to restore functioning in the presence of chronic pain. Although treatments based on cognitive behaviour therapy are beginning to incorporate acceptance strategies, there is still a lack of reliable and valid instruments to assess relevant processes in such interventions. The Chronic Pain Acceptance Questionnaire (CPAQ) was originally constructed as part of the development of an acceptance oriented treatment approach for pain patients. A revised 20-item version of the instrument with two subscales has shown adequate reliability and validity. In the present study, a Swedish translation of CPAQ was evaluated with 611 participants reporting chronic pain and symptoms of whiplash associated disorders. This study sought to further assess the psychometric properties of the instrument and to investigate its relation to another important measure of pain adjustment, the Tampa Scale of Kinesiophobia. Due to low intercorrelations with other items, item 16 was excluded. Exploratory and confirmatory factor analyses supported the previously suggested two-factor solution. Furthermore, the internal consistencies were good for the subscales (activities engagement and pain willingness) as well as the total scale. Hierarchical regression analyses illustrated strong relations with criteria variables (e.g. disability and life satisfaction). In general, the activities engagement subscale contributed more than pain willingness to the prediction of criteria variables. Furthermore, results illustrated that CPAQ explained more variance than the Tampa Scale of Kinesiophobia in pain intensity, disability, life satisfaction, and depression.

Validation of the Chronic Pain Acceptance Questionnaire-8 in an Australian Pain Clinic Sample

“…Since the development of the 20-item measure, confirmatory factor analysis (CFA) conducted by Vowles et al [8] found support for the two-factor model (i.e., Activity Engagement and Pain Willingness). A more recent CFA conducted by Wicksell et al [5] also found that the twofactor solution showed adequate fit to the data in a Swedish translation of the measure. However, the fit was significantly improved following the removal of an item.…”

“…The total score, as well as the subscales of pain willingness and activity engagement, predict disability, quality of life, and distress [1]. The CPAQ contributes unique variance to pain disability, anxiety, and depression when considered in the context of factors known to be associated with chronic pain such as self-efficacy, catastrophizing, and fear of (re)injury/movement [4,5].…”

Latent Class Analysis of the Short and Long Forms of the Chronic Pain Acceptance Questionnaire: Further Examination of Patient Subgroups

“…The Chronic Pain Acceptance Questionnaire [CPAQ: 36] is a 20-item likert (0-6) scale, validated in Swedish [63]. The short version with 8-items' has been validated in English [1; 10; 11] and in Swedish [48].…”

Acceptance: What's in a Name? A Content Analysis of Acceptance Instruments in Individuals With Chronic Pain

“…Within this tradition, McCracken and colleagues 30 started research in chronic pain. Research has identified two core constituents of acceptance: a willingness to experience pain, and the engagement into valued-based life activity despite pain 32, 51,53 . The other approach originates from self-regulatory theories, in which disengagement from blocked goals and reengagement into new actions is considered as an adaptive way of coping with life dynamics 1,4,22,38 .…”