Chronic pain: intrusion and accommodation

Cognitive-behavioral and self-management perspectives on chronic pain emphasize the central role that patient's appraisals of their pain problems may have in determining aspects of the pain experience. This paper reports the development of a self-report instrument measuring two aspects of patients' appraisals of their pain and its impact on their lives. Two reliable and meaningful scales were derived via factor analysis, and a second sample was submitted to confirmatory factor analysis. Further analyses offered support for the internal consistency and stability of the scales. Pain Intrusion is related to greater depressive symptom severity and pain behaviors reflecting affective distress. Pain Accommodation is related to self-reports of greater self-control, viewing oneself as a problem-solver, fewer depressive symptoms, and fewer pain behaviors reflecting affective distress. This report introduces these constructs and the Chronic Pain Intrusion and Accommodation Scales that measure them, and discusses their theoretical and clinical relevance.