Pain Intensity, Psychological Inflexibility, and Acceptance of Pain As Predictors of Functioning in Adolescents with Juvenile Idiopathic Arthritis: a Preliminary Investigation

Overview

Journal J Clin Psychol Med Settings

Publisher Springer

Specialty Psychology

Date 2011 Jun 2

PMID 21630002

Citations 17

Authors

Amanda B Feinstein

Evan M Forman

Akihiko Masuda

Lindsey L Cohen

James D Herbert

L Nandini Moorthy

Donald P Goldsmith

Affiliations

Soon will be listed here.

Abstract

Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic disease associated with pain and maladjustment. This study investigated whether pain, acceptance of pain, and psychological inflexibility uniquely predicted functional disability, anxiety, general quality of life (QOL), and health-related quality of life (HQOL) among adolescents with JIA. Twenty-three adolescents with JIA and pain were recruited from a pediatric rheumatology clinic. Participants completed self-report measures pertaining to the key study variables. A series of multiple regression analyses demonstrated that higher pain uniquely predicted higher functional disability. Greater psychological inflexibility uniquely predicted higher anxiety, lower general QOL, and lower HQOL. Increases in acceptance of pain were found to be uniquely related to increases in general QOL. These data confirm prior findings that pain impacts functioning, and provide preliminary findings that psychological inflexibility and acceptance may be important targets of psychological intervention for youth with JIA and pain to improve functioning and QOL.

Citing Articles

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White K, Zale E, Lape E, Ditre J J Clin Psychol Med Settings. 2024; .

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Exploring Pain Adaptation in Youth With Juvenile Idiopathic Arthritis: Identifying Youth and Parent Resilience Resources and Mechanisms.

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References

Petty R, Southwood T, Manners P, Baum J, Glass D, Goldenberg J . International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004; 31(2):390-2. View

Kratz A, Davis M, Zautra A . Pain acceptance moderates the relation between pain and negative affect in female osteoarthritis and fibromyalgia patients. Ann Behav Med. 2007; 33(3):291-301. PMC: 2593934. DOI: 10.1007/BF02879911. View

Wicksell R, Melin L, Olsson G . Exposure and acceptance in the rehabilitation of adolescents with idiopathic chronic pain - a pilot study. Eur J Pain. 2006; 11(3):267-74. DOI: 10.1016/j.ejpain.2006.02.012. View

McCracken L, Gauntlett-Gilbert J, Eccleston C . Acceptance of pain in adolescents with chronic pain: validation of an adapted assessment instrument and preliminary correlation analyses. Eur J Pain. 2009; 14(3):316-20. DOI: 10.1016/j.ejpain.2009.05.002. View

McCracken L, Velleman S . Psychological flexibility in adults with chronic pain: a study of acceptance, mindfulness, and values-based action in primary care. Pain. 2009; 148(1):141-147. DOI: 10.1016/j.pain.2009.10.034. View

McCracken L . Learning to live with the pain: acceptance of pain predicts adjustment in persons with chronic pain. Pain. 1998; 74(1):21-27. DOI: 10.1016/S0304-3959(97)00146-2. View

Hayes S, Luoma J, Bond F, Masuda A, Lillis J . Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2005; 44(1):1-25. DOI: 10.1016/j.brat.2005.06.006. View

Gong G, Young N, Dempster H, Porepa M, Feldman B . The Quality of My Life questionnaire: the minimal clinically important difference for pediatric rheumatology patients. J Rheumatol. 2006; 34(3):581-7. View

REYNOLDS C, Richmond B . What I Think and Feel: a revised measure of Children's Manifest Anxiety. J Abnorm Child Psychol. 1997; 25(1):15-20. DOI: 10.1023/a:1025751206600. View

10.

Schanberg L, Lefebvre J, Keefe F, Kredich D, Gil K . Pain coping and the pain experience in children with juvenile chronic arthritis. Pain. 1998; 73(2):181-189. DOI: 10.1016/S0304-3959(97)00110-3. View

11.

McCracken L, Vowles K, Eccleston C . Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behav Res Ther. 2005; 43(10):1335-46. DOI: 10.1016/j.brat.2004.10.003. View

12.

Walker L, Greene J . The functional disability inventory: measuring a neglected dimension of child health status. J Pediatr Psychol. 1991; 16(1):39-58. DOI: 10.1093/jpepsy/16.1.39. View

13.

Feldman B, Grundland B, McCullough L, WRIGHT V . Distinction of quality of life, health related quality of life, and health status in children referred for rheumatologic care. J Rheumatol. 2000; 27(1):226-33. View

14.

McCracken L, Vowles K . Psychological flexibility and traditional pain management strategies in relation to patient functioning with chronic pain: an examination of a revised instrument. J Pain. 2007; 8(9):700-7. DOI: 10.1016/j.jpain.2007.04.008. View

15.

McCracken L, Vowles K, Eccleston C . Acceptance of chronic pain: component analysis and a revised assessment method. Pain. 2004; 107(1-2):159-66. DOI: 10.1016/j.pain.2003.10.012. View

16.

Wicksell R, Renofalt J, Olsson G, Bond F, Melin L . Avoidance and cognitive fusion--central components in pain related disability? Development and preliminary validation of the Psychological Inflexibility in Pain Scale (PIPS). Eur J Pain. 2007; 12(4):491-500. DOI: 10.1016/j.ejpain.2007.08.003. View

17.

Sawyer M, Carbone J, Whitham J, Roberton D, Taplin J, Varni J . The relationship between health-related quality of life, pain, and coping strategies in juvenile arthritis--a one year prospective study. Qual Life Res. 2005; 14(6):1585-98. DOI: 10.1007/s11136-004-7710-3. View

18.

Ravelli A, Martini A . Juvenile idiopathic arthritis. Lancet. 2007; 369(9563):767-778. DOI: 10.1016/S0140-6736(07)60363-8. View

19.

Sandstrom M, Schanberg L . Peer rejection, social behavior, and psychological adjustment in children with juvenile rheumatic disease. J Pediatr Psychol. 2004; 29(1):29-34. DOI: 10.1093/jpepsy/jsh004. View

20.

Varni J, Thompson K, Hanson V . The Varni/Thompson Pediatric Pain Questionnaire. I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. Pain. 1987; 28(1):27-38. DOI: 10.1016/0304-3959(87)91056-6. View