An Examination of the Chronic Pain Acceptance Questionnaire CPAQ-R and CPAQ-8 in a Sample of Patients with Chronic Pain in the Southeastern US

Research Objectives: To determine the relationship between pain acceptance and other characteristics: demographics, personality characteristics, time with pain, pain location, and pain catastrophizing.

Design: Retrospective study with chart extraction from patients medical record.

Setting: Rehabilitation Psychology outpatient clinic within a southeastern US academic medical center.

Participants: N=400 individuals seeking presurgical psychological evaluation for spinal cord stimulator implantation or chronic opioid management.

Interventions: N/A

Main Outcome Measures: Demographics, pain specific information, Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R and CPAQ-8) with activity engagement and pain willingness subscales, Pain Catastrophizing Scale (PCS), The Minnesota Multiphasic Personality Inventory 2- Restructured Form (MMPI-2-RF) subscales: somatic complaints, low positive emotions, and cynicism were abstracted. The MMPI-2-RF validity scores were also used to determine the reliable of responses and any invalid protocol resulted in removal of the participant's data from the analysis. Finally on a subset of individuals an objective acceptance rating was given by a clinical psychologist investigator.

Results: CPAQ Total and subscales were highly correlated with pain catastrophizing (r range -0.60 to -0.43), moderately correlated with Low Positive Emotions (MMPI-2-RF RC2, r range -0.44 to -0.18) and Somatic Complaints (MMPI-2-RF RC1, r range -0.32 to -0.16), and mildly correlated with provider assessment of pain acceptance (n=25, Kendall T range: 0.11 to 0.22). Demographic characteristics did not appear strongly associated with CPAQ scores. Latent class analysis suggested 2-class solution for both CPAQ versions, without any clear clinical applicability. A bootstrap analysis resulted in 95% CIs for number of classes from 2-5 for CPAQ-R and 2-7 for CPAQ-8.

Conclusions: In this sample, individuals with low pain acceptance were more likely to engage in catastrophic thinking and had greater depressive symptoms with a tendency toward somatization. Counter to previous study findings, there were no clear natural groupings based on CPAQ scores among participants. In the smaller subset of individuals assessed for objective pain acceptance, there was low concordance with CPAQ scores. This suggests the self-report measure may not be a replacement for provider assessment; however, this requires further investigation with a larger sample.

Author(s) Disclosures: None