Pain Resilience: Issues of Modeling Dynamic Adaptation in Chronic Pain

In recent years, there has been increasing interest in processes and characteristics that may underlie resilient adaptation to chronic pain. With this recent increase in empirical inquiry, there has emerged a degree of ambiguity in terms between pain resilience and other constructs previously connected to effective pain adaptation, such as pain acceptance, psychological flexibility, and pain self-efficacy. Objectives of the current paper included reviewing recent clinical and empirical evidence in the area of chronic pain resilience and offering a synthesis of these findings, with a specific focus on issues of defining and operationalizing this construct, compared to other constructs relevant to pain adaptation. We conclude that resilience is best defined as a dynamic process related to both stable individual characteristics and contextual and state factors, such as goal contexts and affective states. Finally, the implications of this model are discussed in the context of the extant literature on psychological interventions for chronic pain.