title: Measuring avoidance of pain: validation of the Acceptance and Action Questionnaire II-pain version.
abstract: Psychometric research on widely used questionnaires aimed at measuring experiential avoidance of chronic pain has led to inconclusive results. To test the structural validity, internal consistency, and construct validity of a recently developed short questionnaire: the Acceptance and Action Questionnaire II-pain version (AAQ-II-P). Cross-sectional validation study among 388 adult patients with chronic nonspecific musculoskeletal pain admitted for multidisciplinary pain rehabilitation in four tertiary rehabilitation centers in the Netherlands. Cronbach's α was calculated to analyze internal consistency. Principal component analysis was performed to analyze factor structure. Construct validity was analyzed by examining the association between acceptance of pain and measures of psychological flexibility (two scales and sum), pain catastrophizing (three scales and sum), and mental and physical functioning. Interpretation was based on a-priori defined hypotheses. The compound of the seven items of the AAQ-II-P shows a Cronbach's α of 0.87. The single component explained 56.2% of the total variance. Correlations ranged from r=-0.21 to 0.73. Two of the predefined hypotheses were rejected and seven were not rejected. The AAQ-II-P measures a single component and has good internal consistency, and construct validity is not rejected. Thus, the construct validity of the AAQ-II-P sum scores as indicator of experiential avoidance of pain was supported.
authors.affiliation: aDepartment of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen bOCRN Child and Youth Psychiatry, Groningen cFaculty of Behavioural Sciences, University of Twente dRoessingh Research and Development, Enschede eAdelante Rehabilitation Center, Hoensbroek fRijndam Rehabilitation Center, Rotterdam, The Netherlands.
authors.forename: Michiel F
authors.initials: MF
authors.lastname: Reneman
authors.forename: Marco
authors.initials: M
authors.lastname: Kleen
authors.forename: Hester R
authors.initials: HR
authors.lastname: Trompetter
authors.forename: Henrica R
authors.initials: HR
authors.lastname: Schiphorst Preuper
authors.forename: Albère
authors.initials: A
authors.lastname: Köke
authors.forename: Bianca
authors.initials: B
authors.lastname: van Baalen
authors.forename: Karlein M G
authors.initials: KM
authors.lastname: Schreurs
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001362:Avoidance Learning; D058443:Catastrophization / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands; D010147:Pain Measurement / Q000523:psychology* / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers; D012056:Reinforcement, Social; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult