| chronic pain

Psychology and Social Adjustment with Chronic Pain

A Study in Self-Compassion and Psychological Flexibility

From the Journal of Contextual Behavioral Science.


• Psychological flexibility (PF) & self-compassion (SC) predict pain outcomes.

• In people with chronic pain (n=420) PF and SC variables were significantly correlated.

• SC predicted depression, pain interference and work and social adjustment scores.

• SC did not predict pain interference or work & social adjustment when PF was added.

• PF may account for the SC effects on pain interference & work and social adjustment.


Psychological flexibility (PF) and self-compassion (SC) are both associated with positive outcomes for people living with chronic pain. Despite conceptual similarities they have mostly been studied independently. The present study aimed to determine the relationship between PF and SC, and investigate their roles in relation to pain interference, work and social adjustment, and depressive symptoms. 420 participants attending a speciality chronic pain service completed the Self-Compassion Scale Short Form along with measures of PF, pain, interference, functioning, and depression, prior to starting treatment.

PF and SC variables were significantly correlated (r=.38 to .56) and demonstrated a degree of independence. Multiple regression models for all three pain outcomes explained 44% of the variance in pain interference, 36% in work and social adjustment, and 32% in depression. SC accounted for significant unique variance in each of the pain outcomes, however this was no longer significant when PF variables were added to the model for pain interference and work and social adjustment. In conclusion, PF and SC appear to include mostly related and some distinct elements in the context of chronic pain. PF processes may encompass the effects of SC on pain interference and work and social adjustment. However, SC appears to play an independent role in depression. Given the high comorbidity of depression, it may be beneficial to further study the potential for SC-based processes and methods to improve overall wellbeing for people with chronic pain.


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