Perfectionism in Persistent Pain

: The Role of Acceptance and Self-Efficacy

Abstract

Background: Persistent pain is estimated to affect up to one half of the UK population and is highlighted as one of the most prominent causes of disability worldwide (Fayaz et al., 2016; Vos et al., 2012). Perfectionism significantly impacts on an individual’s ability to manage distress and adjust to living with chronic health conditions, however, the relationship between perfectionism, pain acceptance, and pain self-efficacy is yet to be fully understood. The psychological flexibility (PF) model may provide a useful framework in which to understand why individuals who possess perfectionistic traits may have difficulties adapting and managing their persistent pain, in line with theory relating to Acceptance and Commitment Therapy (ACT).

Method: 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. Hierarchical regression analyses were conducted to explore the relationship between perfectionism, pain acceptance, and pain self-efficacy. Mediation analysis examined whether PF mediated the relationship between perfectionism and pain self- efficacy.

Results: Findings demonstrate 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 PF) significantly mediated the relationship between self-critical perfectionism and pain self-efficacy, but not for rigid or narcissistic perfectionism.

Conclusion: The PF 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. Implications for clinical practise and recommendations for future research are considered.

Date of Award	18 May 2023
Original language	English
Awarding Institution	Teesside University
Supervisor	Alan Robert Bowman (Supervisor)