EXAMINING COMMITTED ACTION IN CHRONIC PAIN: FURTHER VALIDATION AND CLINICAL UTILITY OF THE COMMITTED ACTION QUESTIONNAIRE

Behavioral interventions for chronic pain often emphasize altering behavior to maximize effective functioning, particularly by decreasing pain avoidance and increasing engagement with valued activities, a hallmark of Acceptance and Commitment Therapy (ACT). In terms of salient processes within ACT, committed action is considered essential to the pursuit of a meaningful life. To date, however, only one study has examined the association between committed action and salient measures of functioning in the context of chronic pain treatment. The purpose of the present study was to further analyze the reliability of the CAQ in a separate sample of chronic pain patients, confirm the factor structure of the measure, and examine how committed action uniquely contributes to functioning in those with chronic pain. Data were examined from 149 chronic pain patients from an interdisciplinary rehabilitation program in the U.K. who completed the Committed Action Questionnaire (CAQ) and other measures of pain- related functioning. The current study offered several extensions beyond the prior examination of the CAQ in that the two-factor structure of the CAQ was tested using confirmatory factor analysis (CFA) and missing responses were replaced using multiple imputation, a state-of-the-art method for addressing missing data. The final 17-item scale, as well as the two factor-based subscales that comprise the CAQ, demonstrated good internal consistency. The results of the CFA indicated adequate fit for the two-factor solution, with the subscales exhibiting acceptable discriminant validity. Lastly, the regression analyses indicated that the CAQ had significant associations with important measures of psychological functioning, even after accounting for appropriate covariates. The findings indicate the potential for the CAQ to capture committed action in multiple treatment settings and demonstrate the importance of assessing committed action in treating pain, particularly in the context of patient functioning