Validation of the Chronic Pain Acceptance Questionnaire (CPAQ) in an Internet sample and development and preliminary validation of the CPAQ-8

Abstract

This study investigated the psychometric properties of the Chronic Pain Acceptance Questionnaire (CPAQ) in a mixed chronic pain, Internet sample and sought to develop a valid and reliable short form. Questionnaires were completed by 428 respondents, comprising a sample accessed via the Internet (n=319) and a sample who completed a paper and pencil version of the measures (n=109). Using confirmatory factor analysis (CFA) the two-factor structure of the CPAQ in the Internet sample was supported, though a good model fit was only achieved following the removal of one item. The resultant 19 item CPAQ demonstrated good reliability and evidence of validity was obtained for this sample. Data from the Internet sample were used to derive an eight-item short form. The two four-item factors (activity engagement [AE] and pain willingness [PW]) were confirmed using CFA and found to be invariant across both samples with good scale reliability. Higher CPAQ-8 and subscale scores were correlated with less depression and anxiety, pain severity and pain interference, and fewer medical visits for pain. Using structural equation modelling both subscales were found to partially mediate the impact of pain severity on pain interference and emotional distress. In this model AE had stronger associations with outcomes while PW accounted for a small portion of the variance in pain interference and anxiety, but not depression. This study confirmed the two-factor structure of the CPAQ in a mixed chronic pain Internet sample and provides preliminary evidence for the psychometric soundness of the CPAQ-8.

Acceptance: What's in a Name? A Content Analysis of Acceptance Instruments in Individuals With Chronic Pain

“…engagement in activities despite pain and willingness to experience pain 32 . In an attempt to increase time efficiency, Fish and colleagues 16 further reduced the item pool into a compact 8-item version, consisting of four items for both the willingness and engagement component. In this process of modification and adaptation, items representing "pain willingness" have become underrepresented.…”

“…The original Chronic Pain Acceptance Questionnaire (CPAQ-34; Geiser, 1992), the adolescent version of the Chronic Pain Acceptance Questionnaire (CPAQ-A) 29 and the 8-item Chronic Pain Acceptance Questionnaire (CPAQ-8) 16 appeared to be less frequently used. Another frequently used instrument (in 10 out of the 87 articles) is the Illness Cognition Questionnaire (ICQ) 12 .…”

Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention

“…The 8-item measure was also calculated from the CPAQ. Cronbach's alpha for the CPAQ-8 has been reported as 0.77 to 0.89 [11]. The CPAQ-8 correlated with a number of measures of patient functioning [13,11]: it predicted depression and disability, even after accounting for catastrophizing and kinesiophobia [13].…”

“…Cronbach's alpha for the CPAQ-8 has been reported as 0.77 to 0.89 [11]. The CPAQ-8 correlated with a number of measures of patient functioning [13,11]: it predicted depression and disability, even after accounting for catastrophizing and kinesiophobia [13]. The test-retest reliability of the CPAQ over 2 weeks has been reported as 0.83 [20], and the test-retest reliability of the CPAQ-8 over 6 weeks has been reported as 0.81 [14].…”

“…A shortened form of the CPAQ-CPAQ-8-has been developed, and early validation studies suggest it holds similar psychometric properties to the original measure [11][12][13]. In busy clinical practice, the CPAQ-8 may reduce response burden and provide an efficient way to assess program effectiveness.…”