Pain Acceptance in Adolescent Chronic Pain

Objective: Pain acceptance predicts better quality of life, physical functioning, and treatment outcomes in youth with chronic pain. However, we know little about the factors that promote pain acceptance in youth. This study investigated body mindsets and their associations with facets of pain acceptance, specifically pain willingness and activity engagement, in adolescents with chronic pain. Methods: The sample comprised 102 adolescents with chronic musculoskeletal pain (aged 8-17; 72.3% female, 49.5% Caucasian/White) attending a tertiary pain clinic. Hierarchical linear regression analyses examined associations of body mindsets with pain acceptance controlling for demographic factors, pain and mental health symptoms, and basic functioning. Results: There was significant variation in the mindsets that adolescents with chronic pain held about their bodies – some endorsed the mindset that their Body is an Adversary, others endorsed the mindsets that their Body is Responsive or Body is Capable. Hierarchical linear regression analyses indicated that endorsing the mindset that their Body is an Adversary was associated with lower willingness to experience pain, while endorsing the mindset that their Body is Capable was associated with greater engagement in valued activities despite pain, even after accounting for demographic factors, pain characteristics, and basic functioning. Together, all three mindsets explained 6.6-26.8% unique variance in pain acceptance. Discussion: Body mindsets are significantly associated with pain acceptance in youth with chronic pain even after controlling for pain characteristics and basic functioning. Experimental research should investigate whether body mindsets are modifiable in this population and whether they could represent interventional targets fostering pain acceptance.