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

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.