Perfectionism in persistent pain Version 1
Research type
Research Study
Full title
Perfectionism in persistent pain: The role of acceptance, cognitive fusion and self-efficacy.
IRAS ID
257529
Contact name
Alan Bowman
Contact email
Sponsor organisation
Teesside University
Duration of Study in the UK
2 years, 4 months, 1 days
Research summary
Research Summary
Persistent pain is highly prevalent and estimated in over a third of the UK population. Acceptance and Commitment Therapy (ACT) is widely used in the treatment of persistent pain. ACT aims to increase psychological flexibility through six core processes including acceptance and cognitive defusion; ‘unhooking’ thoughts from actions and decreasing their believability. Cognitive defusion has been shown to significantly predict pain acceptance in clinical samples, with self-efficacy also found to consistently predict pain outcomes. More recently, the personality trait of perfectionism has been associated with negative health outcomes in persistent pain. Research suggests that cognitive defusion may moderate the link between perfectionism and pain acceptance in persistent pain, however no empirical data currently exists which examines these factors in a quantifiable way. To address this gap the proposed study aims to examine whether higher levels of perfectionism and cognitive fusion predict lower pain acceptance and self-efficacy in a sample of persistent pain patients. A secondary aim of the study is to test the suitability of The Big Three Perfectionism Scale (BTPS) for use in this client group. In addition to explore whether cognitive thinking styles (about the self, world and future) differ as a function of depression onset (pre- or post- persistent pain).
A quantitative cross-sectional questionnaire design will be adopted in this study. Patients; males and females, aged 18 years or older, accessing pain management and musculoskeletal services at two NHS trust sites will be recruited. Participants will be expected to complete a series of paper questionnaires (lasting up to 1 hour in duration) independently or with the support of the researcher depending on which option they choose. The project will last approximately 26 months and conclude in September 2021. Results will be analysed using multiple regression, confirmatory factor analysis and analysis of variance techniques.
Summary of Results
A cross-sectional study was completed online by 106 participants with persistent pain. Participants completed the big three perfectionism scale, the 8-item chronic pain acceptance questionnaire, the pain self-efficacy questionnaire, and demographic questionnaire.
Findings demonstrated that the relationship between perfectionism and pain acceptance/self-efficacy was not direct. Pain acceptance accounted for 60% of the variability of pain self-efficacy when age and education were controlled for. In addition, pain self-efficacy and level of support emerged as significant predictors of pain acceptance. Pain acceptance (as a measure of psychological flexibility) significantly mediated the relationship between self-critical perfectionism and pain self-efficacy, but not for rigid or narcissistic perfectionism.
The psychological flexibility model provides a useful way in which to understand why individuals with traits of perfectionism are likely to experience difficulties adjusting and managing their persistent pain, specifically in relation to the coping strategies they adopt.
REC name
East of Scotland Research Ethics Service REC 2
REC reference
19/ES/0081
Date of REC Opinion
8 Aug 2019
REC opinion
Further Information Favourable Opinion