title: Acceptance of pain in neurological disorders: associations with functioning and psychosocial well-being.
abstract: OBJECTIVE
  Chronic pain acceptance has been shown to be related to positive adjustment to chronic pain in patients presenting with pain as a primary problem. However, the role of pain acceptance in adjustment to chronic pain secondary to a neurological disorder that is often associated with physical disability has not been determined. The purpose of this study was to examine whether two domains of chronic pain acceptance--activity engagement and pain willingness--predict adjustment to pain, controlling for pain intensity and key demographic and clinical variables in individuals with muscular dystrophy (MD), multiple sclerosis (MS), post-polio syndrome (PPS), or spinal cord injury (SCI).
  
  
  METHODS
  Participants were 508 community-dwelling adults with a diagnosis of MD, MS, PPS, or SCI who also endorsed a chronic pain problem. Participants completed self-report measures of pain acceptance, quality of life, pain interference, pain intensity, depression, and social role satisfaction.
  
  
  RESULTS
  Hierarchical linear regressions indicated that activity engagement predicted lower pain interference and depression, and greater quality of life and social role satisfaction. Pain willingness predicted less pain interference and depression. Together, the two pain acceptance subscales accounted for more variance in outcomes than did self-reported pain intensity.
  
  
  CONCLUSIONS
  Findings correspond with the broader pain acceptance literature, although activity engagement appears to be a more robust predictor of adjustment than does pain willingness. This research supports the need for future studies to determine the extent to which treatments that increase acceptance result in positive outcomes in persons with chronic pain secondary to neurological disorders.
authors: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48109-2800, USA. alkratz@med.umich.edu
authors: Anna L
authors: AL
authors: Kratz
authors: Adam T
authors: AT
authors: Hirsh
authors: Dawn M
authors: DM
authors: Ehde
authors: Mark P
authors: MP
authors: Jensen
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D059350:Chronic Pain / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D055809:Illness Behavior; D008297:Male; D009103:Multiple Sclerosis / Q000523:psychology* / Q000534:rehabilitation; D009136:Muscular Dystrophies / Q000523:psychology* / Q000534:rehabilitation; D010147:Pain Measurement; D016262:Postpoliomyelitis Syndrome / Q000523:psychology* / Q000534:rehabilitation; D011788:Quality of Life / Q000523:psychology; D012917:Social Adjustment; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires