Development and preliminary testing of a screening measure of acceptance and willingness in relation to pain, fatigue, and sadness in chronic pain

Background: The manner in which one responds to the experience of chronic pain is a primary determinant of pain-related distress and disruptions in functioning. In particular, responses to pain that reflect substantial unwillingness, or a lack of acceptance, in relation to pain are reliably associated with greater difficulties in comparison with responses that reflect willingness and acceptance. To date, several multi-item self-report assessments have been developed to evaluate pain-related willingness and acceptance. The purpose of the present research was to develop and evaluate a single item measure, the Acceptance and Willingness screener (AWS). Methods: Participants included 172 individuals with chronic pain. The AWS consisted of 4 statements, reflecting various degrees of acceptance and willingness to experience pain, and participants were asked to endorse the statement that was most reflective of their views. Results: Overall, responses were fairly evenly distributed across the statements (range, 20% to 29%). Correlation and regression results indicated significant associations between AWS responses and measures of pain intensity, depression, pain interference, and engagement in activity. Furthermore, when individuals were grouped according to the statement endorsed, significant between-group differences were indicated across these same measures. Differences were particularly pronounced for groups endorsing the lowest levels of acceptance and willingness and those endorsing the highest. Conclusions: These results correspond with previous work and provide initial support for the validity of a single item screening measure of acceptance and willingness in chronic pain.