Psychometric properties of chronic pain acceptance questionnaires: a systematic review
Open accessAbstract
Background: Theoretically, acceptance of chronic pain (CP) is an important determinant in the functional status and well‐being of patients with CP. Several questionnaires that aim to measure acceptance of CP have been developed. An overview of the psychometric properties of these questionnaires is unavailable. Methods: A systematic review of the literature of the psychometric properties of questionnaires that aim to measure acceptance of CP was performed. Psychometric properties including content construct and criterion validity, internal consistency. agreement, reliability, responsiveness, floor/ceiling effects and interpretability, were assessed using a standardized protocol. All studies were assessed by two observers independent from each other. Results: A total of 23 studies including 4 questionnaires or subscales were identified. The questionnaires/subscales included were the Chronic Pain Acceptance Questionnaire (CPAQ), Illness Cognitions Questionnaire (ICQ), Pain Solutions Questionnaire (PASOL) and Acceptance of Illness Scale (AIS) adapted to pain. When applying the criteria of the protocol, results indicate that none of the questionnaires are currently able to meet all 9 criteria for psychometric quality. Individual questionnaires met between 0 and 3 of the criteria. Conclusions: If strict psychometric quality criteria are applied, none of the questionnaires are currently able to meet all nine criteria for psychometric quality, but overlooking the cumulative results over all the studies conducted, especially for the CPAQ, it can be concluded that information on several important characteristics has been reported and a fairly clear picture emerges about the psychometric properties of the CPAQ.
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The Chronic Pain Acceptance Questionnaire (CPAQ) is perhaps the most widely used measure of psychological flexibility in chronic pain, and its psychometric properties, factor structure, and sensitivity to treatment are well established.
“The CPAQ is perhaps the most widely used measure of psychological flexibility in chronic pain, and its psychometric properties, factor structure, and sensitivity to treatment are well established.47,60”
From Acceptance and commitment therapy for chronic pain: evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation. (2014) · cites this paper as [47]
The Discussion (p. unavailable) identifies the CPAQ as the preferred chronic-pain acceptance questionnaire on psychometric grounds, and the review reports evidence on its factor structure. But it distinguishes acceptance from psychological flexibility and cautions that validity has not been adequately demonstrated. The Responsiveness section says only one study provided change-detection data, without predefined hypotheses; the review does not establish sensitivity to treatment or that the CPAQ is the most widely used measure. (LLM, conf=0.88)
Experimental — accuracy not yet measuredACT is a transdiagnostic approach, meant to be applicable to different types of psychological problems and, in a pain-related context, applicable across a full range of different pain diagnoses.
“ACT is truly a 'transdiagnostic' approach as is sometimes advocated, 61 meaning that it is meant to be applicable to different type of psychological problems, and, in a specifically pain-related context, that it ought to be applicable across a full range of different pain diagnosis. e.g.,60,70”
From The Psychological Flexibility Model: A Basis for Integration and Progress in Psychological Approaches to Chronic Pain Management (2014) · cites this paper as [70]
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References 39 · Cited by 135
Research works printed but not linked: 2
- [4]4. M.F. Reneman et al. / European Journal of Pain 14 (2010) 457-465
- [23]23. McCracken LM. Acceptance of pain predicts adjustment in persons with chronic pain. Pain 1998;74:27.
- Authors
- Reneman, M. F., Dijkstra, A., Geertzen, J. H. B., & Dijkstra, P. U.
- Affiliations
- University Medical Center Groningen (NL)
- University of Groningen (NL)
- Corresponding author
- Reneman, Michiel F.
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2010-05
- Volume
- 14
- Issue
- 5
- Pages
- 457-465
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- OpenAlex
- W2122155515
- Cited by
- 135
- References
- 39
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 11 · 2020: 8 · 2019: 8 · 2018: 7 · 2017: 5 · 2016: 11 · 2015: 16 · 2014: 15 · 2013: 7 · 2012: 11
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- chronic pain acceptance, Chronic Pain Acceptance Questionnaire, psychometric properties, questionnaire validity, reliability statistics, responsiveness, floor and ceiling effects, illness cognitions, Acceptance of Illness Scale
- MeSH terms
- Chronic Disease, Humans, Pain, Psychometrics, Quality of Life, Surveys and Questionnaires, Reproducibility of Results, Illness Behavior
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