McCracken, L. M., Vowles, K. E., & Gauntlett-Gilbert, J. (2007). A prospective investigation of acceptance and control-oriented coping with chronic pain. Journal of Behavioral Medicine, 30, 339-349.
Historically, investigations of coping with chronic pain primarily have sought methods for gaining greater control over pain and pain-related distress. Recently, it has been suggested to expand the framework of coping so that control efforts are redirected from circumstances where they fail, and so that coping can more explicitly incorporate potentially more practical and flexible notions of acceptance. The purpose of the present study was to evaluate the role of control-oriented and acceptance-oriented coping responses for patient functioning using a prospective design. Participants included 120 adult patients with chronic pain who completed measures of coping, pain, disability, depression, and pain-related anxiety at two time points, separated by an average of 3.7 months (SD = 2.6 months). A series of correlation and linear regression analyses was performed to assess the relation of coping responses at initial assessment to functioning at this later point in time. In general, acceptance-oriented responses were associated with better physical, social, and emotional functioning over time while control-oriented responses were associated with greater difficulty in these areas. Struggling to control pain emerged as the most consistent predictor of functioning, demonstrating significant unique relations with later pain, disability, depression, avoidance, and physical performance. These results support the inclusion of acceptance-related processes in our frameworks for understanding adjustment to chronic pain.