The role of values in a contextual cognitive-behavioral approach to chronic pain

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Pain. 2006 Mar 24

The role of values in a contextual cognitive-behavioral approach to

chronic pain.

McCracken LM, Yang SY.

Pain Management Unit, Royal National Hospital for Rheumatic Diseases

and University of Bath, Bath, UK.

Chronic pain can dominate all concerns for individuals suffering with

it, leaving much of their time focused on trying to reduce pain

rather than living their life, as they would most want to do,

according to their values. The purpose of this study was to examine

these processes, the degree of success patients have in following

their values as guides for their actions, and relations between

values-based action and other aspects of daily functioning. For this

study we designed a brief inventory of patient values in domains of

family, intimate relations, friends, work, health, and growth or

learning. One hundred forty, consecutive, adult patients referred to

a pain management unit completed this inventory in addition to

measures of pain, disability, depression, pain-related anxiety, and

acceptance of pain. Results showed that highest importance was placed

on values in the domains of family and health and the least

importance in friends and growth or learning. Highest success was

reported in domains of family and friends and the least success in

health and growth or learning. Significant correlations of overall

success with measures of avoidance and acceptance of pain supported

the validity of scores from the values measure. Success in living

according to values was correlated with measures of disability,

depression, and pain-related anxiety. Regression analysis showed that

success at living according to values predicted variance in

functioning independent of acceptance of pain, supporting its

incremental utility in a contextual analysis of chronic pain and its

potential importance in treatment for chronic pain.