McCracken, L. M. (2010). Toward understanding acceptance and psychological flexibility in chronic pain. Pain, 149, 420-421.
Comments on an article, Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an internet sample and development and preliminary validation of the CPAQ-8, by R. A. Fish et al. (2010). In their paper, the authors address the measurement of acceptance of pain by use of the Chronic Pain Acceptance Questionnaire (CPAQ). They carefully validate an internet administered version of CPAQ in a non-treatment-seeking sample and then develop and validate a shortened eight-item version of the same measure. With confirmatory factor analysis and structural equation modeling they provide support for particular constituent parts of acceptance and show that acceptance partially mediates the relationships between pain severity, pain interference and emotional distress. There has always been potential confusion around acceptance and around the CPAQ in particular. It is worth clarifying the nature of this confusion and how the authors touch on it. The authors choose the terms "engaging" and "disengaging" to describe qualities of acceptance, qualities also reflected in the two subscales of the instrument, Activity Engagement and Pain Willingness, respectively. The confusion arises in how easily the process of examining the parts can lose the importance of the whole. This is human nature and to a certain extent a scientific instinct, part of an inclination to seek the least complex or most frugal explanation.