The Psychological Inflexibility in Pain Scale (PIPS)

Abstract

Psychological flexibility receives increasing attention as the overarching process in Acceptance and Commitment Therapy (ACT). This study investigates the psychometric properties of the Psychological Inflexibility in Pain Scale (PIPS), measuring “avoidance” and “cognitive fusion” with pain, in a heterogeneous clinical sample of 428 chronic pain patients from four rehabilitation centers. Furthermore, the relationship between the PIPS and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ) as a theoretically related measure within ACT is explored. Confirmatory factor analyses replicated acceptable/good model fit and internal consistencies. In a subsample from two rehabilitation centers (n = 237), the PIPS showed moderate to high relationships with aspects of mindfulness, pain interference in daily life, pain disability and mental health, and small relationships with pain intensity and physical functioning. The avoidance subscale explained additional variance in outcome variables beyond the FFMQ, ranging from 4.5 to 15.8%. Outcomes support the psychometric properties of the PIPS in a heterogeneous chronic pain sample. The PIPS and FFMQ measure slightly overlapping, but distinct constructs, and can be used complementary to assess a broad range of processes within ACT. Potential problems with the cognitive fusion subscale are acknowledged for future research.

The Evaluation of the Construct and Convergent Validity and Reliability of Psychological Inflexibility in Pain Scale in Individuals With Migraine Headache

“…This version was related to anxiety (r = 0.54), pain catastrophizing (r = 0.62), and pain acceptance (r = -0.72). Also, another study showed the correlation between PIPS and mindfulness in patients with chronic pain (17). The confirmatory factor analysis (CFA) of German version of this scale in 182 patients with chronic back pain confirmed the main bifactor structure.…”

“…Based on these results, the avoidance subscale was introduced as the appropriate scale, but it was not the case with the cognitive fusion subscale (18). Also, in the study by Trompetter et al (17), showed the problems with the cognitive fusion subscale. However, despite the frequent use of this scale in other countries, no study examined the psychometric features of this scale in Iran.…”

Are Processes in Acceptance & Commitment Therapy (ACT) Related to Chronic Pain Outcomes within Individuals over Time? An Exploratory Study Using n-of-1 Designs

“…The Psychological Inflexibility in Pain Scale (PIPS) assesses psychological inflexibility (Trompetter et al, 2014 ; Wicksell, Lekander, Sorjonen, & Olsson, 2010 ). Two items of the subscale experiential avoidance were used in this study, formulated as ‘Today I… (1) ..avoided doing things when there was a risk it would hurt or make things worse, (2) ..postponed things because of my pain complaints.’ Response alternatives ranged from (0) ‘not true’ to (10) ‘very much true’, with higher scores indicating more experiential avoidance.…”

The Psychological Inflexibility in Pain Scale (PIPS): Validity and Reliability of the Japanese Version for Chronic Low Back Pain and Knee Pain

“…Recently, PIPS has been translated to Spanish, 15 Dutch, 16 German, 17 Iran, 18,19 Greek, 20 and Chinese 21 shown to have acceptable validity and reliability. However, there is yet no Japanese version of the PIPS.…”