Adolescent acceptance of pain: confirmatory factor analysis and further validation of the chronic pain acceptance questionnaire, adolescent version

J Pain. 2011 May;12(5):591-9. doi: 10.1016/j.jpain.2010.11.004. Epub 2011 Mar 22.


Preliminary reports suggest that acceptance of pain is an important construct when assessing and treating adolescents with chronic pain. Although the Chronic Pain Acceptance Questionnaire, Adolescent version (CPAQ-A) appears to be a promising tool, it has been evaluated in only 1 study. The current results present a confirmatory analysis of the CPAQ-A and validity data collected independently from the developers of the scale. A sample of 109 adolescents with chronic pain completed the CPAQ-A, as well as measures of pain characteristics, functional impairment, depression, anxiety, and pain self-efficacy. Results of the confirmatory factor analysis indicate the previously reported 2-factor solution provides a good fit to the data, and has acceptable internal consistency. The CPAQ-A correlated strongly with disability, depression, anxiety, and self-efficacy. It correlated only moderately with pain intensity and was not correlated with pain frequency or duration of pain. When entered last into a hierarchical regression model predicting disability, acceptance accounted for more variance than pain intensity, depression, anxiety, and self-efficacy. Results supported the internal consistency and validity of the CPAQ-A as a measure of pain acceptance in this sample of adolescents with chronic pain. Use of the CPAQ-A may provide valuable insight into the manner in which adolescents adapt to chronic pain and can guide acceptance-based treatment.

Perspective: This article strengthens the psychometric support for a measure of chronic pain acceptance in adolescents. Acceptance-based treatment has been shown to reduce disability in preliminary research targeting adolescents with chronic pain; the CPAQ-A may be useful for assessing the degree to which acceptance-based approaches may be indicated for a given patient.

Publication types

  • Validation Study

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Anxiety / psychology
  • Chronic Disease
  • Depression / psychology
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Pain / psychology*
  • Pain Measurement
  • Psychiatric Status Rating Scales
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Self Efficacy*
  • Surveys and Questionnaires