title: Pain acceptance, hope, and optimism: relationships to pain and adjustment in patients with chronic musculoskeletal pain.
abstract: There is growing interest in the role that positive aspects of psychological adjustment, such as pain acceptance, hope, and optimism, may play in explaining adjustment in persons suffering from persistent pain. This study conducted in obese patients with persistent musculoskeletal pain (N = 89) examined the degree to which pain acceptance and hope explained pain intensity, pain unpleasantness, psychological distress, and pain-related disability, after controlling for the effects of optimism. In correlational analyses, pain acceptance and optimism were associated with psychological distress and pain disability with hope being related to only psychological distress. Pain acceptance, optimism, and hope were not significantly associated with pain. Hierarchical linear regression (HLR) analyses found that pain acceptance remained a significant predictor of psychological distress and pain disability after controlling for optimism, demographic, and medical variables. HLR analyses found that hope was not a significant predictor of psychological distress after controlling for optimism, pain acceptance, and demographic and medical variables. The results of this study are important because they indicate that pain acceptance, hope, and optimism are all related to pain adjustment. They also highlight the importance of controlling for optimism when examining the effects of pain acceptance and hope on pain adjustment.
  
  
  CONCLUSIONS
  In a sample of obese patients with persistent musculoskeletal pain, pain acceptance was a significant predictor of psychological distress and pain disability even after controlling for optimism, demographic, and medical variables. These results add to the growing literature on the importance of pain acceptance in understanding adjustment to persistent pain.
authors.affiliation: Duke University Medical Center, Durham, North Carolina 27705, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Wright
authors.forename: Anava A
authors.initials: AA
authors.lastname: Wren
authors.forename: Tamara J
authors.initials: TJ
authors.lastname: Somers
authors.forename: Mark C
authors.initials: MC
authors.lastname: Goetz
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Fras
authors.forename: Billy K
authors.initials: BK
authors.lastname: Huh
authors.forename: Lesco L
authors.initials: LL
authors.lastname: Rogers
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
mesh_terms: D000223:Adaptation, Psychological; D059350:Chronic Pain / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000523:psychology*; D009765:Obesity / Q000150:complications