Revisiting Chronic Pain Patient Profiling: An Acceptance-based Approach in an Online Sample Jessica C. Payne-Murphy 1 * and Abbie O. Beacham 2 1 Department of Psychology, University of Colorado Denver, Denver, CO 80217, USA 2 Department of Psychology, Xavier University, Cincinnati, OH 45207-6511, USA Over 116 million Americans experience chronic pain, incurring an annual cost of $635bn in healthcare and lost work. Acceptance-based therapies have gained increasing recognition for improving functional outcomes. In our online chronic pain sample, we predicted that (1) patients would cluster into low, medium and high groups of chronic pain acceptance and (2) positive affect, negative affect and per- ceived disability scores would differ overall by cluster, with the most positive outcomes found in the high cluster and the least found in the low cluster. Participants completed the Chronic Pain Acceptance Questionnaire, Positive and Negative Affect Scales and the Pain Disability Index. A k-means cluster analysis was conducted using activity engagement (AE) and pain willingness (PW) totals from the Chronic Pain Acceptance Questionnaire. As predicted, cluster analysis specified three groups: low AE/low PW, high AE/high PW and medium AE/medium PW. Significant multivariate analysis of covari- ance results were obtained according to Wilks’ λ (0.55), F(6,266) = 15.39, p < 0.01, and indicated differ- ences in positive affect, negative affect and perceived disability within each cluster. Follow-up analyses of covariance revealed mean differences in the predicted directions: the high-high group showed the most positive affect and the least negative affect and perceived disability. Conversely, the low-low group displayed the least positive affect (M = 20.28, SD = 7.86), the most negative affect (M = 28.05, SD = 9.33) and perceived disability (M = 49.57, SD = 9.46). The presence of these clusters introduces key questions about the possibility of creating tailored interventions based on cluster pro- files. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message: • Higher levels of Acceptance are associated with better functional and affective outcomes for chronic pain patients. • Lower Acceptance is associated with poorer functional and affective outcomes. • Tailoring interventions using Acceptance-based profiling may improve chronic pain therapies. Keywords: Acceptance, Chronic Pain, Perceived Disability FAR REACHING EFFECTS OF CHRONIC PAIN Chronic pain (CP) is a debilitating and prevalent health concern for over 116 million Americans that contributes to an estimated annual cost of $635bn in disability com- pensation, healthcare costs and lost work productivity (Institute of Medicine of the American Academies, 2011). CP is defined by 3 months or more of ‘an unpleasant sen- sory and emotional experience associated with actual or potential tissue damage’ (International Association for the Study of Pain, 2011). Empirical findings have led researchers to believe that the aetiology of CP is a combination of phys- iological, psychological, social, cultural and behavioural factors (Turk & Okifuji, 2002). Medical Manifestations and Functional Disability in Chronic Pain The experience and report of pain is a subjective and pri- vate one, which is composed of one’s perception not only of the pain severity but also of the suffering related to the pain (Gatchel, 2004). Empirical findings suggest that per- ceived disability, or one’s perception of his or her ability, impacts medical and functional outcomes in those with CP (Arnstein et al., 1999; Geisser, Robinson, Miller, & Bade, 2003). In fact, perceived disability is found to affect these outcomes regardless of the primary cause or nociceptive origin, duration and severity of pain. Multiple studies sug- gest that fear of pain, fear avoidance, lower self-efficacy and depression contribute to both higher perceived and actual disability (Crombez, Vlaeyen, Heuts, & Lysens, 1999; Denison, Asenlof, & Lindberg, 2004; Geisser, Haig, & Theisen, 2000; Swinkels-Meewisse *Correspondence to: Jessica C. Payne-Murphy, Department of Psy- chology, University of Colorado Denver, P.O. Box 173364, Denver, CO 80217, USA. E-mail: Jessica.Payne-Murphy@ucdenver.edu Clinical Psychology and Psychotherapy Clin. Psychol. Psychother. 22, 240–248 (2015) Published online 5 February 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/cpp.1886 Copyright © 2014 John Wiley & Sons, Ltd.