The Cognitive Fusion Questionnaire:A Preliminary Study of Psychometric Properties and Prediction of Functioning in Chronic Pain

Background: Acceptance and Commitment Therapy and the psychological flexibility model on which it is based are growing interests for those researching and treating chronic pain. One part of this model is a therapeutic process called cognitive defusion. Cognitive defusion is a process of experiencing a distinction between thoughts and the events or people they describe. This process is intended to reduce the dominating psychological influence of thoughts without necessarily changing the content or frequency of the thoughts. There are recently developed measures of this process but little study of it in people with chronic pain.Methods: This study explored the reliability and validity of the Cognitive Fusion Questionnaire (CFQ) within a chronic pain population. A total of 326 adults with chronic pain completed this measure and a set of other standard clinical measures at the start of treatment in a specialty chronic pain service in the United Kingdom.Results: An exploratory factor analysis revealed an interpretable 2-factor structure within the items of the CFQ. Internal consistency reliability was good (alpha = 0.87). In the analyses of validity the CFQ significantly correlated with general psychological acceptance and pain-related acceptance as expected. In multiple regression analyses, which included relevant patient background variables, pain, and acceptance of pain, cognitive fusion contributed significantly to the explained variance in the prediction of 5 of 6 dependent variables tested.Discussion: The CFQ may be a useful measure for further research and treatment development.