Chronic Pain Research

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Outcome Studies: Chronic Pain

  • Vowles, K. E., & McCracken, L. M. (2008). Acceptance and values-based action in chronic pain: A study of treatment effectiveness and process. Journal of Consulting and Clinical Psychology, 76, 397-407.
  • Wicksell, R.K., Ahlqvist, J., Bring, A., Melin, L. & Olsson, G.L. (in press). Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial. Cognitive Behaviour Therapy

    Included people (adults) with longstanding pain due to whiplash (WAD). A 10-session protocol was compared with a wait list control group, and found significant improvements following treatment in functioning and life satisfaction, as well as in psychological flexibility (as measured with PIPS).

  • Wicksell R.K, Melin, L. & Olsson, G.L. (2007). Exposure and acceptance in the rehabilitation of children and adolescents with chronic pain.European Journal of Pain, 11, 267-274.

    Open trial with 14 adolescents. Good outcomes that continue to improve through follow up.

  • McCracken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy, 43, 1335-1346.

    108 chronic pain patients with a long history of treatment are followed through an ACT-based 3-4 week residential treatment program. Measures improved from initial assessment to pre-treatment on average only 3% (average of 3.9 month wait), but improved on average 34% following treatment. 81% of these gains were retained through a 3 month follow up. Changes in acceptance predicted positive changes in depression, pain related anxiety, physical disability, psychosocial disability, and the ability to stand. Positive outcomes were also seen in a timed walk, decreased medical visits, daily rest due to pain, pain intensity, and decreased pain medication use.

  • Dahl, J., Wilson, K. G., & Nilsson, A. (2004). Acceptance and Commitment Therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behavior Therapy, 35, 785-802.

    A small randomized controlled trial shows that a four hour ACT intervention reduced sick day usage by 91% over the next six months compared to treatment as usual in a group of chronic pain patients at risk for going on to permanent disability.

Mediation Analyses

Case Studies: Chronic Pain

  • Kleen, M., & Jaspers, J. P. C. (2007). Women should not be allowed to run. Acceptance and commitment therapy (ACT) with a pain disorder. Translated from: Vrouwen horen niet hard te lopen. Acceptance and commitment therapy (ACT) bij een pijnstoornis. Gedragstherapie, 40, 7-26.
  • Wicksell, R. K., Dahl, J., Magnusson, B., & Olsson, G. L. (2005). Using Acceptance and Commitment Therapy in the rehabilitation of an adolescent female with chronic pain: A case example. Cognitive and Behavioral Practice, 12, 415-423. Shows dramatic improvement with a 14 year old chronic pain patient using a values focused ACT protocol.

Micro/Component Studies: Chronic Pain

  • A number of other micro/component studies have examined the impact of brief ACT interventions on performance in pain inducing preparations and are listed here.

Correlational Studies: Chronic Pain

  • McCracken, L. M., & Vowles, K. E. (2007). Psychological flexibility and traditional pain management strategies in relation to patient functioning with chronic pain: An examination of a revised instrument.Journal of Pain, 8, 339-349.
  • McCracken, L. M. (2006). Toward a fully functional, flexible, and defused approach to pain in young people. Cognitive and Behavioral Practice, 13, 182-184.
  • McCracken, L. M., & Eccleston, C. (2006). A comparison of the relative utility of coping and acceptance-based measures in a sample of chronic pain sufferers. European Journal of Pain, 10(1), 23-29.
  • McCracken, L. M. (2005). Social context and acceptance of chronic pain: The role of solicitous and punishing responses. Pain, 113, 155-159.
  • McCracken, L. M. (1999). Behavioral constituents of chronic pain acceptance: Results from factor analysis of the Chronic Pain Acceptance Questionnaire. Journal of Back & Musculoskeletal Rehabilitation, 13, 93-100.
  • McCracken, L. M. (1998). Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain, 74, 21-27.

    This study is based on a pain related early version of the AAQ. Greater acceptance of pain was associated with reports of lower pain intensity, less pain-related anxiety and avoidance, less depression, less physical and psychosocial disability, more daily uptime, and better work status. A relatively low correlation between acceptance and pain intensity showed that acceptance is not simply a function of having a low level of pain. Regression analyses showed that acceptance of pain predicted better adjustment on all other measures of patient function, independent of perceived pain intensity. This work is replicated, refined and extended in McCracken, L. M. & Eccleston, C. (2003). Coping or acceptance: What to do about chronic pain. Pain, 105, 197-204. and McCracken, L. M. , Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: Component analysis and a revised assessment method. Pain, 107, 159-166.