Pain acceptance in adolescents: Development of a short form of the CPAQ-A
Open accessAbstract
OBJECTIVE: Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain. This variable has been previously measured using the Chronic Pain Acceptance Questionnaire for Adolescents (CPAQ-A, McCracken, Gauntlett-Gilbert, & Eccleston, European Journal of Pain, 14, 316-320, 2010). We set out to create a short, eight-item, form of this instrument that retained its factor structure and clinical utility. METHODS: We used data collected from two independent samples of adolescents attending residential treatment for disabling chronic pain (N = 187 and N = 159). Both groups completed the 20-item CPAQ-A and indices of functioning and distress. We carried out item reduction and confirmatory factor analysis (CFA) on the first sample, repeating this on the second sample and examining the new scale's correlations with clinically relevant variables. RESULTS: An eight-item scale was created with four items assigned to each established factor (Pain Willingness and Activity Engagement). CFA confirmed this factor structure and it replicated in Sample 2. The new scale (the CPAQ-A8) was sensitive to treatment and correlated as well with clinically important variables as its full-length version. Some items in the new scale differed from the adult CPAQ-8. CONCLUSIONS: Measures of pain acceptance have been previously developed and validated in pediatric and adult samples. This study showed that pain acceptance can be indexed by a brief, yet factorially valid, short form of the CPAQ-A that uses fewer than 50% of the items of the full-length scale and has demonstrated acceptable validity and sensitivity-to-treatment.
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CPAQ-A has been used in clinical studies to measure therapeutic efficacy.
“and CPAQ-A has been used in clinical studies to measure therapeutic efficacy [42,43].”
Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain.
“Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain, and CPAQ-A has been used in clinical studies to measure therapeutic efficacy [42,43].”
Cites
Acceptance and commitment therapy: model, processes and outcomes
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.006 · Cited by 6,587 · see citing works
Structural Equation Modeling With AMOS: Basic Concepts, Applications, and Programming, Third Edition
Byrne, B. M. (2016) · doi:10.4324/9781315757421 · Cited by 4,653 · see citing works
Effect size, confidence interval and statistical significance: a practical guide for biologists
Nakagawa, S., & Cuthill, I. C. (2007) · Biological Reviews · doi:10.1111/j.1469-185x.2007.00027.x · Cited by 3,835 · cited 1× · see citing works
“1996, summarised in Nakagawa & Cuthill, 2007), reporting a statistic equivalent to Cohen’s d (Nakagawa and Cuthill, 2007).”
BackgroundThe epidemiology of chronic pain in children and adolescents revisited: A systematic review
King, S., Chambers, C. T., Huguet, A., MacNevin, R. C., McGrath, P. J., Parker, L., & MacDonald, A. J. (2011) · Pain · doi:10.1016/j.pain.2011.07.016 · Cited by 1,688 · see citing works
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.08.002 · Cited by 1,120 · cited 8× · see citing works
“Processes of change in psychological flexibility in an interdisciplinary group-based treatment for chronic pain based on Acceptance and Commitment Therapy.”
MethodInfluentialAcceptance of chronic pain: component analysis and a revised assessment method
McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004) · Pain · doi:10.1016/j.pain.2003.10.012 · Cited by 1,101 · see citing works
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Eccleston, C., Palermo, T. M., Williams, A. C. D. C., Lewandowski Holley, A., Morley, S., Fisher, E., & Law, E. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003968.pub4 · Cited by 745 · see citing works
Veehof, M. M., Trompetter, H. R., Bohlmeijer, E. T., & Schreurs, K. M. G. (2016) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2015.1098724 · Cited by 737 · see citing works
Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain
McCracken, L. M. (1998) · Pain · doi:10.1016/s0304-3959(97)00146-2 · Cited by 685 · see citing works
Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress.
McCracken, L. M., & Vowles, K. E. (2014) · American Psychologist · doi:10.1037/a0035623 · Cited by 627 · see citing works
Introduction to Structural Equation Modeling using IBM SPSS Statistics and AMOS
Blunch, N. J. (2013) · SAGE Publications Ltd eBooks · doi:10.4135/9781526402257 · Cited by 564 · see citing works
Acceptance and Values-Based Action in Chronic Pain: A Study of Treatment Effectiveness and Process
Vowles, K. E., & McCracken, L. M. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.3.397 · Cited by 500 · see citing works
McCracken, L. M., & Morley, S. (2014) · The Journal of Pain · doi:10.1016/j.jpain.2013.10.014 · Cited by 464 · see citing works
Wicksell, R. K., Melin, L., Lekander, M., & Olsson, G. L. (2009) · Pain · doi:10.1016/j.pain.2008.11.006 · Cited by 393 · see citing works
Birnie, K. A., Hundert, A. S., Lalloo, C., Nguyen, C., & Stinson, J. (2018) · Pain · doi:10.1097/j.pain.0000000000001377 · Cited by 345 · see citing works
Fish, R. A., McGuire, B., Hogan, M., Morrison, T. G., & Stewart, I. (2010) · Pain · doi:10.1016/j.pain.2009.12.016 · Cited by 306 · see citing works
Development and validation of the pain response inventory for children
Walker, L. S., Smith, C. A., Garber, J., & Van Slyke, D. A. (1997) · Psychological Assessment · doi:10.1037/1040-3590.9.4.392 · Cited by 292 · see citing works
McCracken, L. M., & Gutiérrez-Martínez, O. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.02.004 · Cited by 283 · see citing works
Eccleston, C. (2003) · Archives of Disease in Childhood · doi:10.1136/adc.88.10.881 · Cited by 276 · see citing works
Vowles, K. E., McCracken, L. M., & Eccleston, C. (2007) · European Journal of Pain · doi:10.1016/j.ejpain.2006.12.007 · Cited by 253 · see citing works
Pielech, M., Ryan, M., Logan, D., Kaczynski, K., White, M. T., & Simons, L. E. (2014) · Pain · doi:10.1016/j.pain.2014.08.035 · Cited by 185 · see citing works
Eccleston, C., Jordan, A., McCracken, L. M., Sleed, M., Connell, H., & Clinch, J. (2005) · Pain · doi:10.1016/j.pain.2005.08.025 · Cited by 172 · see citing works
Gauntlett-Gilbert, J., Connell, H., Clinch, J., & McCracken, L. M. (2013) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jss098 · Cited by 131 · cited 2× · see citing works
“However, the CPAQ-A has performed well in the detection of treatment effects in two treatment studies (Gauntlett-Gilbert et al., 2013; Weiss et al., 2013)”
BackgroundMethodSelf-citationWeiss, K. E., Hahn, A. L., Wallace, D. P., Biggs, B. K., Bruce, B. K., & Harrison, T. E. (2013) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jst028 · Cited by 116 · see citing works
Empirically supported treatments in pediatric psychology: recurrent abdominal pain
Janicke, D. M. (1999) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/24.2.115 · Cited by 106 · see citing works
The Impact of Adolescent Chronic Pain on Functioning: Disentangling the Complex Role of Anxiety
Cohen, L. L., Vowles, K. E., & Eccleston, C. (2009) · Journal of Pain · doi:10.1016/j.jpain.2009.09.009 · Cited by 105 · see citing works
Kalapurakkel, S., A. Carpino, E., Lebel, A., & E. Simons, L. (2015) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu091 · Cited by 105 · see citing works
McCracken, L. M., Gauntlett‐Gilbert, J., & Eccleston, C. (2010) · European Journal of Pain · doi:10.1016/j.ejpain.2009.05.002 · Cited by 104 · see citing works
Self-citationElander, J., Robinson, G., Mitchell, K., & Morris, J. (2009) · Pain · doi:10.1016/j.pain.2009.06.004 · Cited by 98 · see citing works
McCracken, L. M., Gutiérrez-Martínez, O., & Smyth, C. (2013) · Health Psychology · doi:10.1037/a0028093 · Cited by 87 · see citing works
Palermo, T. M., Law, E. F., Bromberg, M., Fales, J., Eccleston, C., & Wilson, A. C. (2016) · Pain · doi:10.1097/j.pain.0000000000000508 · Cited by 82 · see citing works
Kemani, M. K., Kanstrup, M., Jordan, A., Caes, L., & Gauntlett-Gilbert, J. (2018) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsy031 · Cited by 78 · see citing works
Wallace, D. P., McCracken, L. M., Weiss, K. E., & Harbeck-Weber, C. (2015) · The Journal of Pain · doi:10.1016/j.jpain.2014.11.013 · Cited by 63 · see citing works
Martin, S., Wolters, P. L., Toledo‐Tamula, M. A., Schmitt, S. N., Baldwin, A., Starosta, A., Gillespie, A., & Widemann, B. (2016) · American Journal of Medical Genetics, Part A · doi:10.1002/ajmg.a.37623 · Cited by 61 · see citing works
Lauwerier, E., Caes, L., Damme, S. V., Goubert, L., Rosseel, Y., & Crombez, G. (2015) · Journal of Pain · doi:10.1016/j.jpain.2015.01.001 · Cited by 59 · see citing works
Wallace, D. P., Harbeck‐Weber, C., Whiteside, S. P. H., & Harrison, T. E. (2011) · Journal of Pain · doi:10.1016/j.jpain.2010.11.004 · Cited by 58 · see citing works
Feinstein, A. B., Forman, E. M., Masuda, A., Cohen, L. L., Herbert, J. D., Nandini Moorthy, L., & Goldsmith, D. P. (2011) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-011-9243-6 · Cited by 57 · cited 3× · see citing works
“One such psychological intervention is Acceptance and Commitment Therapy (ACT) and, following its rise in popularity and evidence base (Hayes, Levin, Plumb-Vilardaga, Villatte, & Pistorello, 2013), the processes targeted within ACT have been investigated to understand positive clinical outcomes within adolescent chron…”
BackgroundMethodInfluentialAcceptance and commitment therapy for children and adolescents with physical health concerns
Wicksell, R. K., Kanstrup, M., Kemani, M. K., Holmström, L., & Olsson, G. L. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2014.12.029 · Cited by 31 · see citing works
Clementi, M. A., Kao, G. S., & Monico, E. C. (2017) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx125 · Cited by 20 · see citing works
Casier, A., Goubert, L., Vervoort, T., Theunis, M., Huse, D., Baets, F. D., Matthys, D., & Crombez, G. (2013) · Pain Research and Management · doi:10.1155/2013/276923 · Cited by 10 · see citing works
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Kohut, S. A., & Stinson, J. (2016) · Paediatrics & Child Health · doi:10.1093/pch/21.5.258 · Cited by 1 · see citing works
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Simons, L. E., Harrison, L. E., O'Brien, S. F., Heirich, M. S., Loecher, N., Boothroyd, D. B., Vlaeyen, J. W. S., Wicksell, R. K., Schofield, D., Hood, K. K., et al. (2019) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2019.100448 · Cited by 24 · see citing works
“Pain acceptance Patient report on the Chronic Pain Acceptance Questionnaire for Adolescents-short form (CPAQ-A8 [35])will be used to assess pain acceptance in the child.”
MethodSimons, L. E., Harrison, L. E., Boothroyd, D. B., Parvathinathan, G., Van Orden, A. R., O'Brien, S. F., Schofield, D., Kraindler, J., Shrestha, R., Vlaeyen, J. W. S., et al. (2024) · Pain · doi:10.1097/j.pain.0000000000003010 · Cited by 19 · see citing works
Shear, D., Harrison, L. E., O’Brien, S., Khazendar, Z., Lyons, S., Morgan, J. J., Chan, S. K., Feinstein, A. B., & Simons, L. E. (2022) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000001040 · Cited by 13 · see citing works
Simmonds, M. K., Dick, B. D., Verrier, M. J., Reid, K. L., Jamieson-Lega, K., Balisky, K. J., Davey, A. E., & Freeman, K. M. (2022) · Children · doi:10.3390/children9091293 · Cited by 1 · see citing works
“Acceptance of pain is a predictor of pain-related disability and treatment outcome in adolescents with pain, and CPAQ-A has been used in clinical studies to measure therapeutic efficacy [42,43].”
Method
- Authors
- Gauntlett-Gilbert, J., Alamire, B., & Duggan, G. B.
- Affiliations
- Bath Centre for Pain Services, Royal United Hospitals Bath, Royal National Hospital for Rheumatic Diseases
- Royal National Hospital for Rheumatic Diseases (GB)
- Venue
- Journal of Pediatric Psychology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-11-28
- Volume
- 44
- Issue
- 4
- Pages
- 453-462
- ISSN
- 0146-8693 (ISSN-L)
- 1465-735X
- OpenAlex
- W2902441438
- Cited by
- 18
- References
- 41
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 6 · 2020: 1 · 2019: 2
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.uwe.ac.uk
- Licence
- Locations
- Journal of Pediatric Psychology (publishedVersion)
- PubMed (publishedVersion)
- UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- pain acceptance, adolescents, short-form scale development, chronic pain, factor structure, pain-related disability
- MeSH terms
- Adaptation, Psychological, Adolescent, Child, Female, Humans, Male, Pain Measurement, Psychometrics, Surveys and Questionnaires, Reproducibility of Results, Chronic Pain
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