title: A Cross-Sectional Study of Psychological Comparison Processes That May Underlie the Acceptance of Chronic Pain.
abstract: Acceptance of chronic pain varies between patients but may also be expected to develop and change within patients. In this latter framework, the present study explored three psychological processes that may contribute to changes in acceptance: social comparisons, temporal comparisons and counterfactual comparisons. In general, these comparisons are used to cope with negative life events, and they may also play a role in acceptance of pain. In this study, the two subscales of the Chronic Pain Acceptance Questionnaire (Activity Engagement and Pain Willingness) were complemented with a scale of Affective Acceptance. Using linear regression analyses, data from these three acceptance scales were regressed on three scales of temporal comparison processes, four scales of social comparison processes and one scale of counterfactual comparisons. The results showed that the comparison processes explained up to 37% of the variance in acceptance, especially a higher frequency of thinking of one's present condition in relation to a condition in the past, and feeling bad when comparing with others who are doing better, were consistently related to lower acceptance. These explorative results may inspire experimental studies to influence comparison processes and, eventually, to address those comparison processes in interventions for patients with chronic pain to improve acceptance. Copyright © 2015 John Wiley & Sons, Ltd.
  
  
  CONCLUSIONS
  In addition to beliefs indicating Activity Engagement and Pain Willingness, Affective acceptance of pain may also be a relevant dimension and manifestation of acceptance Social comparisons, temporal comparisons and counterfactual comparisons are related to acceptance of pain In patients with pain psychological comparison processes can be relevant in diagnosing possible causes of non-optimal acceptance of chronic pain Practitioners may try to influence each of the three types of psychological comparison processes in individuals and observe the effects.
authors.affiliation: University of Groningen, Groningen, the Netherlands.
authors.forename: Harald
authors.initials: H
authors.lastname: Orfgen
authors.affiliation: University of Groningen, Groningen, the Netherlands.
authors.forename: Arie
authors.initials: A
authors.lastname: Dijkstra
mesh_terms: D000223:Adaptation, Psychological; D059350:Chronic Pain / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Acceptance; Chronic Pain; Counterfactual Comparison; Social Comparison; Temporal Comparison