Chronic Pain Acceptance Questionnaire

by Psychology Roots

Chronic Pain Acceptance Questionnaire

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About Chronic Pain Acceptance Questionnaire

Scale Name

Chronic Pain Acceptance Questionnaire

Author Details

Lance M. McCracken, Kevin E. Vowles, and Christopher Eccleston

Translation Availability

Not Sure

Chronic Pain Acceptance Questionnaire
Chronic Pain Acceptance Questionnaire


The Chronic Pain Acceptance Questionnaire (CPAQ) was originally developed as a 34-item instrument to assess acceptance in chronic pain patients, largely by modifying the item pool for the Acceptance and Action Questionnaire. Early psychometric evaluations supported a four-factor solution of the scale.

However, the revised version of the instrument consists of two subscales measuring the degree of engagement in life activities regardless of pain (activity engagement) and the willingness to experience pain without efforts to avoid or control it (pain willingness). The reliability and validity of the CPAQ have been demonstrated in several studies.

Also, its’ ability to predict functioning among people with chronic pain has been shown repeatedly. Participants rate the items on a scale from 0 (never true) to 6 (always true), with higher scores indicating more activity engagement/pain willingness. A recent analysis with a Swedish version of CPAQ, including a CFA, further supports the psychometric properties of the two-factor solution. In this study, CPAQ was also found to be a better predictor than TSK in life satisfaction, functioning, and depression.

Administration, Scoring and Interpretation

  • Obtain consent: Before administering the questionnaire, ensure informed consent is obtained from the participant, explaining the purpose of the questionnaire and their right to withdraw at any time.
  • Gather information: Collect relevant demographic information like age, gender, and pain diagnosis, as these can sometimes affect interpretation of the scores.
  • Choose the appropriate version: Depending on the research needs or clinical setting, choose either the 20-item or 8-item version of the CPAQ.
  • Provide clear instructions: Explain to the participant that the questionnaire asks about their thoughts and feelings regarding their chronic pain.
  • Emphasize honesty: Encourage them to answer each statement honestly, reflecting their current experience.
  • Clarify instructions: Address any questions or concerns the participant might have about the instructions or specific items.
  • Provide the questionnaire: Present the participant with a clean copy of the chosen CPAQ version.
  • Allow sufficient time: Ensure adequate time for the participant to complete the questionnaire comfortably.
  • Offer assistance (optional): If needed, offer clarification on specific items or provide assistance with reading or writing for participants with disabilities.
  • Collect completed questionnaires: Once completed, collect the questionnaires in a secure and confidential manner.
  • Check for completeness: Ensure all items are completed and no data is missing.
  • Data entry: Carefully enter the responses into a data analysis software or spreadsheet for further analysis.

Reliability and Validity

  • The Chronic Pain Acceptance Questionnaire (CPAQ) has been extensively studied for its reliability and validity. Here are some key points based on the search results:
  • Reliability: Studies have shown that the CPAQ demonstrates good internal consistency and test-retest reliability. This indicates that the questionnaire consistently measures acceptance of chronic pain over time.
  • Validity: The CPAQ has been found to have good construct validity, meaning it measures what it intends to measure – acceptance of chronic pain. Additionally, the instrument has shown convergent validity with measures of pain intensity, disability, and psychological distress.
  • Psychometric Properties: Research has provided evidence for the dimensionality, reliability, and validity of the CPAQ in various populations, including internet samples and clinical settings. The development of a shorter 8-item version called CPAQ-8 further supports the robustness of the instrument.
  • The CPAQ-Revised demonstrates very good to excellent internal consistency, with alphas of .82 (Activity engagement) and .78 (Pain willingness).
  • Validity: The CPAQ shows moderate to high correlations with measures of avoidance, distress, and daily functioning. The 2 factors of the CPAQ-revised have been found to significantly predict pain-related disability and distress, thus demonstrating predictive validity.

Available Versions



McCracken, L. M., Vowles, K. E., & Eccleston, C. (2004). Acceptance of chronic pain: component analysis and a revised assessment method. Pain107(1-2), 159-166.

McCracken, L. M., Vowles, K. E., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour research and therapy43(10), 1335-1346.

Important Link

Scale File:

Frequently Asked Questions

What is the Chronic Pain Acceptance Questionnaire (CPAQ)?
The Chronic Pain Acceptance Questionnaire is a tool developed to assess an individual’s acceptance of chronic pain, consisting of 20 items measuring Activity Engagement and Pain Willingness.

How is the CPAQ administered?
The CPAQ is typically administered to individuals with chronic pain conditions. Participants rate the truth of statements on a Likert scale from 0 to 6, indicating the frequency of each statement’s truthfulness.

What are the psychometric properties of the CPAQ?
Studies have shown that the CPAQ demonstrates good reliability and validity, with evidence supporting its internal consistency, test-retest reliability, and construct validity in measuring acceptance of chronic pain.

Why is assessing pain acceptance important?
Assessing pain acceptance is crucial as it can help healthcare professionals understand how individuals cope with chronic pain, guide treatment strategies, and improve outcomes by focusing on valued activities and personal goals.

Can the CPAQ be used in different populations?
Yes, the CPAQ has been validated in various populations, including internet samples and clinical settings, demonstrating its applicability across diverse groups and cultural contexts.

How does pain acceptance relate to quality of life in patients with chronic pain?
Higher levels of pain acceptance have been associated with reduced levels of depression and anxiety, improved pain management, and better overall quality of life for individuals living with chronic pain conditions


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