The Role of Acceptance and Pain Intensity in Chronic Pain Disability and Physical Functioning

Chronic pain is a wide spread, debilitating disorder. With the development of Relational Frame Theory, the pathological nature of avoidance behaviors has been brought to the forefront of chronic pain research and acceptance based therapies are being extensively studied. Although interdisciplinary chronic pain rehabilitation programs draw from a variety of disciplines, they incorporate many components of acceptance therapy. The purpose of the present study was to examine the relationship between chronic pain acceptance, pain intensity, disability, and physical functioning. This study sought to answer the following questions: 1) Do patients who complete an interdisciplinary chronic pain rehabilitation program differ from those who drop out by demographics or outcome measures?, 2) Is an interdisciplinary chronic pain rehabilitation program effective in promoting acceptance of chronic pain and physical functioning while decreasing disability?, 3) What is the relationship between chronic pain acceptance, pain intensity, disability, and physical functioning?, and 4) Will changing levels of acceptance interact with changes in disability and physical functioning independent of pain intensity? Of the 487 patients admitted into a Cleveland area chronic pain program between 2006 and 2007, 393 patients completed the program and were included in the main analyses. Pre- and post-treatment measures included pain intensity, CPAQ, UAB, PDI, and a six-minute treadmill test. Chi-square and independent sample t-tests were performed to compare completers and non-completers, paired sample t-tests were used to determine the effectiveness of the program, and Pearson correlations and hierarchal multiple regression were used to examine the relationship of the outcome variables. The tests were considered significant at the .05 level. Program completers differed significantly from non-completers in age, primary complaint, and marital status. Program completers significantly improved across all outcome measures. Greater acceptance and lowe