Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up

Andrew J. Cook, Eric C. Meyer*, Lianna D. Evans, Kevin E. Vowles, John W. Klocek, Nathan A. Kimbrel, Suzy Bird Gulliver, Sandra B. Morissette

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

War veterans are at increased risk for chronic pain and co-occurring neurobehavioral problems, including posttraumatic stress disorder (PTSD), depression, alcohol-related problems, and mild traumatic brain injury (mTBI). Each condition is associated with disability, particularly when co-occurring. Pain acceptance is a strong predictor of lower levels of disability in chronic pain. This study examined whether acceptance of pain predicted current and future disability beyond the effects of these co-occurring conditions in war veterans. Eighty trauma-exposed veterans with chronic pain completed a PTSD diagnostic interview, clinician-administered mTBI screening, and self-report measures of disability, pain acceptance, depression, and alcohol use. Hierarchical regression models showed pain acceptance to be incrementally associated with disability after accounting for symptoms of PTSD, depression, alcohol-related problems, and mTBI (total adjusted R2=.57, p<.001, δR2=.03, p=.02). At 1-year follow-up, the total variance in disability accounted for by the model decreased (total adjusted R2=.29, p<.001), whereas the unique contribution of pain acceptance increased (δR2=.07, p=.008). Pain acceptance remained significantly associated with 1-year disability when pain severity was included in the model. Future research should evaluate treatments that address chronic pain acceptance and co-occurring conditions to promote functional recovery in the context of polytrauma in war veterans.

Original languageEnglish
Pages (from-to)25-32
Number of pages8
JournalBehaviour Research and Therapy
Volume73
DOIs
Publication statusPublished - 01 Oct 2015

Keywords

  • Acceptance
  • Chronic pain
  • Disability
  • Functioning
  • Posttraumatic stress disorder
  • Veterans

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

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