Kanzler et al., 2019

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APA Citation: 

Kanzler, K. E., Pugh, J. A., McGeary, D. D., Hale, W. J., Mathias, C. W., Kilpela, L. S., Karns-Wright, T. E., Robinson, P. J., Dixon, S. A., Bryan, C. J., Moring, J. C., & McCracken, L. M. (2019). Mitigating the Effect of Pain Severity on Activity and Disability in Patients with Chronic Pain: The Crucial Context of Acceptance. Pain Medicine, 20(8), 1509–1518. https://doi.org/10.1093/pm/pny197

Publication Topic: 
ACT: Empirical
Publication Type: 
Article
Language: 
English
Keyword(s): 
Chronic Pain, Acceptance, Activity, Disability, Functioning
Abstract: 

Objective
The purpose of this study was to examine the effect of pain severity on activity levels and physical disability in the context of high pain acceptance. We hypothesized that pain acceptance moderates the effect of pain severity on general activity and physical disability, such that at higher levels of acceptance, the deleterious effect of pain is mitigated.

Methods
Two hundred seven patients with chronic pain were recruited from three clinics in a large southwestern military treatment facility. Participants completed an anonymous self-report battery of standardized measures, including the Chronic Pain Acceptance Questionnaire, modified Oswestry Disability Index, and Pain Severity and General Activity subscales of the West Haven-Yale Multidimensional Pain Inventory.

Results
Chronic pain acceptance was found to significantly moderate relations between pain severity and general activity (b  =  0.0061, t(198) = 2.75, P = 0.007, 95% confidence interval [CI] = 0.002 to 0.011) and pain severity and disability (b  =  0.036, t(193) = –2.564, P = 0.011, 95% CI = –0.063 to –0.008). In the context of higher acceptance, the negative effect of pain on activity and disability appeared reduced. Conversely, in the context of low acceptance, the effect of pain on disability appeared accentuated at all levels of pain severity.

Conclusions
Higher acceptance mitigated both activity level and disability in a military-affiliated clinical sample of patients with chronic pain. Results further establish the role of acceptance in relation to functioning in a unique sample of people with chronic pain. These findings have implications for understanding and enhancing functioning in chronic pain populations.