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A confirmatory factor analysis of the Resilience Scale adapted to chronic pain (RS-18): new empirical evidence of the protective role of resilience on pain adjustment

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Abstract

Purpose

Recent attention has focused on resilience as an important process in the experience and management of chronic pain. In this context, resilience is considered as a psychological factor that promotes adaptive responses to pain and pain-related life adversities. Current research suggests that it is a relevant variable in the prediction of pain adjustment among chronic pain patients. Recently, it was adapted the Resilience Scale to patients suffering chronic musculoskeletal pain (RS-18). The aims of this study were to confirm the internal structure of the RS-18 and to present new empirical evidence regarding its validity.

Methods

A sample of 592 patients with chronic musculoskeletal back pain completed a battery of instruments to assess resilience, anxiety sensitivity, catastrophizing, fear-avoidance beliefs, hypervigilance, pain acceptance, and pain adjustment variables (pain intensity, emotional distress, functional impairment, and daily functioning).

Results

Confirmatory factor analysis supported the validity of the RS-18 and a single-factor solution. A series of moderated multiple regression analysis showed that resilience is a relevant psychological variable that not only independently predicts better pain adjustment, but also moderates the relationships between several psychological pain-related variables and pain adjustment variables.

Conclusions

These findings give empirical support to the consideration of resilience as a protective variable in chronic pain adjustment and highlight the consideration that improving resilient behaviour could be an important target for the treatment of pain patients.

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Abbreviations

AIC:

Akaike information criterion

ASI:

Anxiety Sensitivity Index

BCC:

Browne–Cudeck criterion

CFI:

Comparative fit index

CPAQ:

Chronic Pain Acceptance Questionnaire

FABQ:

Fear-Avoidance Beliefs Questionnaire

HADS:

Hospital Anxiety and Depression Scale

IFI:

Impairment and Functioning Inventory

NNFI:

Non-normed fit index

PCS:

Pain Catastrophizing Scale

PVAQ:

Pain Vigilance and Awareness Questionnaire

RMSEA:

Root mean square error of approximation

RS:

Resilience Scale

TLI:

Tucker–Lewis index

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Acknowledgments

This work was partly supported by a grant from the Spanish Ministry of Economy and Competitiveness (PSI2013-42512-P).

Conflict of interest

This work has not received financial arrangements that may represent a possible conflict of interest.

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Authors and Affiliations

  1. Universidad de Málaga, Department of Personality, Assessment and Psychological Treatment, Málaga, Spain

    Gema T. Ruiz-Párraga, Alicia E. López-Martínez, Rosa Esteve & Carmen Ramírez-Maestre

  2. Facultad de Psicología, Universidad de Málaga, Campus de Teatinos s/n, 29071, Málaga, Spain

    Alicia E. López-Martínez

  3. The Resilience Center, Worden, MT, USA

    Gail Wagnild

Authors
  1. Gema T. Ruiz-Párraga
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  2. Alicia E. López-Martínez
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Correspondence to Alicia E. López-Martínez.

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Ruiz-Párraga, G.T., López-Martínez, A.E., Esteve, R. et al. A confirmatory factor analysis of the Resilience Scale adapted to chronic pain (RS-18): new empirical evidence of the protective role of resilience on pain adjustment. Qual Life Res 24, 1245–1253 (2015). https://doi.org/10.1007/s11136-014-0852-z

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