Measuring avoidance of pain: validation of the Acceptance and Action Questionnaire II-pain version
Abstract
Psychometric research on widely used questionnaires aimed at measuring experiential avoidance of chronic pain has led to inconclusive results. To test the structural validity, internal consistency, and construct validity of a recently developed short questionnaire: the Acceptance and Action Questionnaire II-pain version (AAQ-II-P). Cross-sectional validation study among 388 adult patients with chronic nonspecific musculoskeletal pain admitted for multidisciplinary pain rehabilitation in four tertiary rehabilitation centers in the Netherlands. Cronbach's α was calculated to analyze internal consistency. Principal component analysis was performed to analyze factor structure. Construct validity was analyzed by examining the association between acceptance of pain and measures of psychological flexibility (two scales and sum), pain catastrophizing (three scales and sum), and mental and physical functioning. Interpretation was based on a-priori defined hypotheses. The compound of the seven items of the AAQ-II-P shows a Cronbach's α of 0.87. The single component explained 56.2% of the total variance. Correlations ranged from r=-0.21 to 0.73. Two of the predefined hypotheses were rejected and seven were not rejected. The AAQ-II-P measures a single component and has good internal consistency, and construct validity is not rejected. Thus, the construct validity of the AAQ-II-P sum scores as indicator of experiential avoidance of pain was supported.
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Die einfaktorielle Lösung der deutschen AAQ-II-P klärte mit 61,5 % etwas mehr Varianz auf als bei der niederländischen Stichprobe (56,2 %).
“Die einfaktorielle Lösung klärte mit 61,5 % sogar etwas mehr Varianz auf als bei der niederländischen Stichprobe (56,2 %).”
From Messung von schmerzbezogener Erlebensvermeidung: Analyse des Acceptance and Action Questionnaire-II-Pain bei Patienten mit chronischem Schmerz (2021) · cites this paper as [47]
Männliche Schmerzpatienten berichteten höhere Werte in schmerzbezogener Erlebensvermeidung, was sich ebenfalls in der niederländischen Version findet.
“Männliche Schmerzpatienten berichteten höhere Werte in schmerzbezogener Erlebensvermeidung, was sich ebenfalls in der niederländischen Version findet.”
From Messung von schmerzbezogener Erlebensvermeidung: Analyse des Acceptance and Action Questionnaire-II-Pain bei Patienten mit chronischem Schmerz (2021) · cites this paper as [47]
Die deutsche Version des AAQ-II-P hat eine gute Reliabilität und weist hinsichtlich Zuverlässigkeit und Faktorenstruktur hohe Vergleichbarkeit mit der Originalversion auf.
“Die deutsche Version des AAQ-II‑P hat eine gute Reliabilität und weist hinsichtlich Zuverlässigkeit und Faktorenstruktur hohe Vergleichbarkeit mit der Originalversion auf.”
From Messung von schmerzbezogener Erlebensvermeidung: Analyse des Acceptance and Action Questionnaire-II-Pain bei Patienten mit chronischem Schmerz (2021) · cites this paper as [47]
Die interne Konsistenz der deutschen Version des AAQ-II-P ist vergleichbar mit derjenigen der Originalversion.
“Die interne Konsistenz der deutschen Version des AAQ-II‑P ist vergleichbar mit derjenigen der Originalversion [47].”
From Messung von schmerzbezogener Erlebensvermeidung: Analyse des Acceptance and Action Questionnaire-II-Pain bei Patienten mit chronischem Schmerz (2021) · cites this paper as [47]
Das Lübecker Patientenkollektiv liegt mit einem AAQ-II-P-Skalengesamtwert von M = 29,9 geringfügig über dem Wert der niederländischen Stichprobe (M = 28,0).
“Das Lübecker Patientenkollektiv liegt mit einem Skalengesamtwert von M = 29,9 geringfügig über dem Wert der niederländischen Stichprobe (M = 28,0).”
From Messung von schmerzbezogener Erlebensvermeidung: Analyse des Acceptance and Action Questionnaire-II-Pain bei Patienten mit chronischem Schmerz (2021) · cites this paper as [47]
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- Authors
- Reneman, M. F., Kleen, M., Trompetter, H. R., Schiphorst Preuper, H. R., Köke, A., van Baalen, B., & Schreurs, K. M. G.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- Reneman, Michiel F.
- Venue
- International Journal of Rehabilitation Research
- Published
- 2014-06
- Volume
- 37
- Issue
- 2
- Pages
- 125-129
- ISSN
- 0342-5282 (ISSN-L)
- OpenAlex
- W2077941363
- Cited by
- 20
- References
- 16
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 2 · 2018: 1 · 2017: 2 · 2014: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Rehabilitation Research (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- University of Twente Research Information (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- University of Twente Research Information (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- experiential avoidance, chronic pain, psychometric validation, construct validity, internal consistency, factor structure, pain acceptance, psychological flexibility, pain catastrophizing, multidisciplinary pain rehabilitation, musculoskeletal pain
- MeSH terms
- Activities of Daily Living, Adaptation, Psychological, Adolescent, Adult, Aged, Avoidance Learning, Cross-Sectional Studies, Defense Mechanisms, Disability Evaluation, Female, Humans, Male, Middle Aged, Motivation, Netherlands, Pain Measurement, Psychometrics, Surveys and Questionnaires, Rehabilitation Centers, Reinforcement, Social, Reproducibility of Results, Young Adult, Catastrophization, Chronic Pain
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