European Journal of Pain最新文献

{"title":"Correlates of chronic pain onset and recovery in the CoLaus cohort.","authors":"Giada Dirupo, Jean-Benoît Rossel, Nicolas Fournier, Audrey D'Andrea, Peter Vollenweider, Isabelle Decosterd, Marc René Suter, Chantal Berna","doi":"10.1002/ejp.4712","DOIUrl":"https://doi.org/10.1002/ejp.4712","url":null,"abstract":"<p><strong>Background: </strong>Only few previous cohort studies examined simultaneously predictors of chronic pain (CP) onset and recovery. Furthermore, these studies used various sociodemographic and pain-related characteristics, without standardized measures of sleep and depression. The present study aimed at expanding and strengthening these findings in a large Swiss population.</p><p><strong>Methods: </strong>We analysed data from a longitudinal cohort (n = 4602) collected at two time points separated by 5 years in Lausanne, Switzerland. We studied through two independent multivariable logistic regression models, the predictors of CP onset and recovery, including socio-demographic data as well as standardized measures of sleep and mood.</p><p><strong>Results: </strong>Chronic pain was reported by 43.1% and 44.4% of participants, with 11.6% at the second follow-up reporting moderate or intense pain. Neuropathic pain, regardless of intensity, had a more negative impact on quality of life. An inferential model (n = 1331) identified the male sex as predictive for recovering from CP. Older age, being overweight or obese (compared to normal weight), higher depression scores and pain medication intake were predictive for sustained pain at the second follow-up. A second model (n = 1886) identified being overweight or obese (compared to normal weight), low quality of sleep and being a former smoker (compared to a non-smoker) as predictive for developing CP, while the male sex was lowering the risk.</p><p><strong>Conclusions: </strong>While sex and weight are associated with both recovery and new CP onset, separate variables also need to be considered in these processes, underlining specific factors to be addressed, depending on the context, whether preventive or therapeutic.</p><p><strong>Significance statement: </strong>Multivariable models in a Swiss cohort (N = 4602) associate male sex, not taking pain medication, normal weight, lower depression scores and younger age with recovery from chronic pain, while females, obese or overweight, having worse sleep and former smokers are associated with onset of new chronic pain. These common and separate factors need to be considered in treatment and prevention efforts.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the association between patient-drawn pain diagrams and psychological and physical health variables: A large-scale study of patients with low back pain.","authors":"Steen Harsted, Natalie H S Chang, Casper Nim, James J Young, David T McNaughton, Søren O'Neill","doi":"10.1002/ejp.4711","DOIUrl":"https://doi.org/10.1002/ejp.4711","url":null,"abstract":"<p><strong>Background: </strong>Despite the use of Patient-Drawn Pain Drawings (PDPDs) in clinical settings, their validity as indicators of psychological distress remains debated. We aimed to assess the association between PDPD areas and physical health and psychological variables.</p><p><strong>Methods: </strong>This study analysed digitally-drawn PDPDs from 15,345 chronic low back pain (LBP) patients at a Danish outpatient hospital unit. We employed a novel quantitative approach to calculate four log-transformed geometric pain areas for each PDPD. We assessed six psychological constructs and seven physical health variables. Associations were modelled using multivariable linear regression.</p><p><strong>Results: </strong>Increasing leg pain intensity (estimates from 0.12 to 0.25), disability (estimates from 0.3 to 0.14), and pain duration (estimates from 0.10 to 0.33) had the strongest associations with increasing pain areas. Conversely, increasing fear of movement (estimates from -0.02 to -0.05) and catastrophizing (estimates from -0.02 to -0.03) were associated with slight reductions in pain areas. Anxiety and depression had the weakest and most uncertain relationships to pain area size.</p><p><strong>Conclusions: </strong>Increasing levels of leg pain intensity, pain duration, and pain-related disability were consistently associated with larger geometric pain areas in PDPDs. Conversely, the associations between the psychological constructs and the geometric pain areas exhibited varying directions and were notably weaker. Clinicians are encouraged to focus on the association of PDPDs with physical symptoms rather than psychological conditions during clinical assessments.</p><p><strong>Significance statement: </strong>This large-scale study demonstrates that extensive pain areas in pain drawings drawn by LBP patients do not signify psychological distress. Our findings reveal that these pain representations are more closely linked to increased pain intensity, pain duration, and disability rather than being independently associated with psychological factors. Clinicians are encouraged to focus on the association of extensive pain areas with physical symptoms rather than psychological distress during clinical assessments.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Fabry disease in patients with chronic pain: Lessons from the DOUFAB and DOUFABIS studies.","authors":"Chloé Angelini, Claire Bar, Marie Pierre Baudier, Patricia Fergelot, Gwenaëlle Lancelot, Caroline Rooryck, Dominique P Germain, Firas Jabbour, Anne-Sophie Blanchet, Alexandre Cauchie, Elisabeth Sarrazin, Rémi Bellance, Jean-Pascal Lefaucheur, Julie Bismuth, Stéphanie Ranque-Garnier, Virginie Corand, Isabelle Coupry, Cyril Goizet","doi":"10.1002/ejp.4708","DOIUrl":"https://doi.org/10.1002/ejp.4708","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease (FD) is a rare X-linked lysosomal disorder caused by alpha-galactosidase deficiency consecutive to a pathogenic variant in the GLA gene. Age at onset is highly variable, with a wide clinical spectrum including frequent renal, cardiac, skin and nervous system manifestations. Since pain can be an indicator of underlying FD, we wanted to estimate the prevalence of FD in a population of chronic pain patients.</p><p><strong>Methods: </strong>Two studies, DOUFAB and DOUFABIS, were carried out in expert centers for chronic pain to assess the prevalence of FD by measuring alpha galactosidase A activity in men and analysing the GLA gene in women.</p><p><strong>Results: </strong>Analysis of 893 patients, essentially adults, led to the diagnosis of FD in one female patient, now treated with enzyme replacement therapy.</p><p><strong>Conclusions: </strong>The prevalence of FD is estimated about 1/1000 in our population of men and women suffering from various chronic pain. This is nearly the prevalence of FD observed in other previously screened high-risk populations with renal failure.</p><p><strong>Significance: </strong>Although a systematic search for FD does not seem relevant in the context of unexplained chronic pain in adults, a positive family history of FD or the presence of additional FD related organ features must lead to consider this rare disease diagnosis. Therefore, pain specialists need to be aware of main features of FD, including pain characteristics.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The measurement of \"high-impact chronic pain\": Limitations and alternative methods.","authors":"Daniel L Riddle, Levent Dumenci","doi":"10.1002/ejp.4710","DOIUrl":"https://doi.org/10.1002/ejp.4710","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pain is known to be an important construct in clinical practice and a particular form of chronic pain, high-impact chronic pain (HICP), has gained recent interest and attention by pain clinicians, epidemiologists, and clinical researchers. The purpose of our Topical Review is to describe the historical development of measures of HICP and to explore the psychometric properties of HICP as well as to present alternative measurement methods.</p><p><strong>Methods: </strong>We identified strengths and weaknesses of the psychometric characteristics of HICP measures. Limitations of existing HICP measures were discussed and summarized and alternatives to current methods were proposed.</p><p><strong>Results: </strong>HICP operational definitions show variability across studies. All definitions cannot be correct, but which ones are incorrect cannot be determined as there is no gold standard. Random measurement error and recall bias are among the other limitations of current HICP measures. Model-based definitions of HICP, the discrete (for epidemiologic applications) and continuous (for clinical applications) latent variable models are discussed as likely superior alternatives to current methods.</p><p><strong>Conclusions: </strong>Limitations of existing HICP methods are discussed and alternative development approaches to HICP measures are presented. The use of either discrete or continuous latent variable models would improve upon the psychometric characteristics of current HICP evidence. Examples are used to illustrate the benefits of latent variable models over traditional observed variable conceptualizations as the measurement of HICP continues to develop.</p><p><strong>Significance statement: </strong>This work takes the position that current methods of measuring high impact chronic pain (HICP) likely contain substantial error. We have endorsed an alternative approach for several psychometrically grounded reasons. We recommend that future work consider the discrete latent variable framework for dichotomous measures of HICP and the continuous latent variable framework for continuous measures of HICP. The paper provides illustrative examples of these methods for a different patient reported measure that is lacking a gold standard, much like HICP measures.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of opioid use among patients with low back pain: Association to work absence.","authors":"Johan Liseth Hansen, Knut Reidar Wangen","doi":"10.1002/ejp.4706","DOIUrl":"https://doi.org/10.1002/ejp.4706","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is a leading reason for opioid use and a closer examination of opioid use and productivity losses among these patients is needed. We identify opioid use trajectories using a group-based trajectory model (GBTM) and estimate productivity losses across the trajectories.</p><p><strong>Methods: </strong>Patients diagnosed with LBP in Swedish specialty care between 2011 and 2015, between the ages of 20 and 60, were included. Two GBTMs were estimated on monthly opioid use (converted to oral morphine equivalents) during the two 12-month periods preceding and following diagnosis. Productivity losses were estimated using the human-capital approach.</p><p><strong>Results: </strong>In total, 147,035 patients were included. The mean age at diagnosis was 43 years of age and 49% of the patients were male. A qualitative assessment of the identified groups in the GBTM models was made based on the patterns of opioid use. We chose three pre-diagnosis groups characterized as 'Pre-low' (N = 109,492), 'Pre-increase' (N = 27,336) and 'Pre-high' (N = 10,207). Similarly, four post-diagnosis groups were chosen and characterized as 'Post-low' (N = 73,287), 'Post-decrease' (N = 39,446), 'Post-moderate' (N = 20,001) and 'Post-high' (N = 13,595). Only 50% of the patients in the 'Pre-high' group were in the 'Post-high' group. The total productivity losses by the pre-diagnosis groups were more than 2.7 billion Euros over the total 6-year study period.</p><p><strong>Conclusion: </strong>This study highlights how patients with LBP and high use of opioids are highly correlated before and after diagnosis. Patients with high use of opioids also exhibit high work absence and productivity losses.</p><p><strong>Significance statement: </strong>This was the first study to estimate trajectories of opioids in the two time periods before and after a diagnosis of low back pain. For the first time, productivity losses were also estimated across the identified opioid use trajectories.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporomandibular disorder pain is associated with increased sick leave and reduced health related quality of life","authors":"S. Vallin,&nbsp;P. Liv,&nbsp;B. Häggman-Henrikson,&nbsp;C. M. Visscher,&nbsp;F. Lobbezoo,&nbsp;A. Lövgren","doi":"10.1002/ejp.2314","DOIUrl":"10.1002/ejp.2314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Temporomandibular disorders (TMD) are the most common reason for chronic pain in the orofacial area and significantly impact the lives of those affected. The role of lifestyle factors in TMD, however, remains less explored. This cohort study aims to estimate TMD prevalence by addressing potential selection biases and to evaluate the association between TMD and lifestyle factors with a specific focus on sick leave and health related quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>By linking data on TMD in the general population in Västerbotten, northern Sweden (<i>n</i> = 180,000) to health survey data (<i>n</i> = 120,000), information on sociodemographic factors and quality of life was available for 52,961 individuals (50.6% women) with a mean age of 53 years. We applied inverse probability weighting to adjust for selection bias and Poisson regression to explore associations with TMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TMD prevalence was 9.2% during the study period, being higher in women (12.9%) than men (5.4%). Weighting for varying visiting frequencies did not affect TMD prevalence (average difference 0.4% points). Individuals with TMD, especially women, reported more sick leave and use of pain medication, with a significant association between TMD and increased sick leave (prevalence ratio 1.89, 95% CI: 1.78–2.01) among both women and men. In addition, TMD was associated with a lower health related quality of life (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The association of TMD with sick leave highlights the condition's profound impact on the lives of affected individuals. These findings underscore the influence of TMD on work life and the burden of TMD on the societal level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance Statement</h3>\u0000 \u0000 <p>The findings provide insight into how TMD affect individuals, by incorporating lifestyle factors, social determinants and the impact of sick leave at a population level. By incorporating these areas into the study of TMD, we can deepen our understanding of how TMD affects individuals' lives. This approach may also create opportunities to develop more comprehensive strategies to address TMD, focusing on broader implications beyond the clinical symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.2314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of glial cell changes in individuals with chronic low back pain: A commentary on Shraim et al.","authors":"Camille Fauchon","doi":"10.1002/ejp.4707","DOIUrl":"10.1002/ejp.4707","url":null,"abstract":"&lt;p&gt;This journal recently published a paper by Shraim et al., entitled ‘Neuroinflammatory activation in sensory and motor regions of the cortex is related to sensorimotor function in individuals with low back pain maintained by nociplastic mechanisms: a preliminary proof-of-concept study’ (Shraim et al., &lt;span&gt;2024&lt;/span&gt;). Using simultaneous positron emission tomography (PET)/functional MR imaging and the radioligand ([&lt;sup&gt;18&lt;/sup&gt;F]-FEMPA), which binds to the translocator protein (TSPO), this study demonstrated potential glial changes in individuals with chronic low back pain (LBP) located in the primary sensory and motor cortices (S1/M1). Neuroinflammatory glial activation was higher in nociplastic LBP than nociceptive LBP and pain-free groups. This activation was correlated with various markers of sensorimotor functions (e.g. sensitivity to hot/cold stimuli and intracortical facilitation assessed by TMS) and patient characteristics (e.g. poor sleep, depression, disability and BMI). This is an ambitious proof-of-concept study, creating new testable hypotheses about the differential mechanisms of distinct types of pain. However, the study has certain limitations that need to be considered. PET targeting 18 kDa TSPO is widely used for localizing inflammation in vivo, but its quantitative interpretation remains uncertain (Nutma et al., &lt;span&gt;2023&lt;/span&gt;). Furthermore, given that the experiment was conducted on a small sample of individuals with LBP, it remains to be established whether these findings can be generalized and specific to a subtype of LBP associated with central sensitization.&lt;/p&gt;&lt;p&gt;Over the last few years, a plethora of works have pointed out the importance of precise pain phenotyping to optimize individual treatments of chronic pain. Clinical (QST, quantification of sensory systems), electrophysiological (high-density EEG/MEG/TMS) and functional imaging (MRI or PET) approaches have proved useful to disclose at the individual level some particularities of brain activity associated with different expression of LBP. However, they have rarely been used jointly to assess the contribution of glial cells to this process and to develop models of abnormal brain functioning profiles in LBP. In this sense, the findings from Shraim et al. (&lt;span&gt;2024&lt;/span&gt;) may provide a valuable therapeutic basis for treating those with central sensitization resulting in nociplastic LBP by targeting neuroinflammation in S1/M1; but although the study is proof-of-principle study, the sample size is very small, particularly in the nociceptive and nociplastic subgroups (&lt;i&gt;N&lt;/i&gt; = 4 and N = 5). A larger sample size is required to confirm whether a causal relationship exists and to describe potentially relevant pathogenetic differences. Another challenge specific to pain biomarker development pertains to the complexity of pain and the impact of individual factors such as sex differences. All participants with nociplastic LBP were female. Studies that do not exami","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejp.4707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and epidemiological characteristics of chronic pain in the Spanish population. Results from the pain barometer.","authors":"M Dueñas, H De Sola, A Salazar, A Esquivia, S Rubio, I Failde","doi":"10.1002/ejp.4705","DOIUrl":"https://doi.org/10.1002/ejp.4705","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain (CP) is a public health problem worldwide.</p><p><strong>Aim: </strong>To update the prevalence of CP and compare the clinical and social characteristics of people with CP with those with non-chronic continuous pain and a group without pain.</p><p><strong>Methods: </strong>An observational cross-sectional study was carried out in a representative sample of 7058 adults from the Spanish population. Sociodemographic data, the presence of CP and non-chronic continuous pain, characteristics of pain, limitations on activities of daily living (ADL), the presence and level of anxiety and depression (HADS), quality of life (SF-12v2) and social support (DUKE) were collected. Descriptive and bivariate analyses were performed.</p><p><strong>Results: </strong>The prevalence of CP was 25.9% (95% CI;24.8-26.9) and that of non-chronic continuous pain was 7.7% (95% CI;7.1-8.3). Women presented a higher prevalence of both CP (30.5% vs. 21.3%) and non-chronic continuous pain (8.8% vs. 6.6%). CP was more common in the group between 55 and 75 years old (30.6%, 95% CI = 28.6-32.6%), non-chronic continuous pain affected most the population between 18 and 34 years old (11.2%, 95% CI = 9.6-12.7%). The median duration of CP was 4 years. The lumbar was the most frequent pain site (58.1%), and 27.1% did not know the cause. A greater frequency of limitations on ADL, more anxiety and depression, and worse quality of life were shown among the subjects with CP.</p><p><strong>Conclusion: </strong>CP affects one in four Spanish people and impairs the mental, physical and social health. Differences exist by sex and age in its frequency. Identifying subjects with non-chronic continuous pain is fundamental to prevent their pain from becoming chronic.</p><p><strong>Significance statement: </strong>Indicating the main aspects where this work adds significantly to existing knowledge in the field, and if appropriate to clinical practice. Due to its high prevalence and impact on quality of life, chronic pain has become one of the main health problems nowadays. Attention must be paid to it both from a clinical and social perspective, trying to raise awareness among the population of its possible causes and consequences. In routine clinical practice, greater consideration is given to groups of people with a higher prevalence of chronic pain, such as women and people with middle age, and with no chronic pain to prevent the appearance of chronic pain.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remembering Prof. Manfred Zimmermann","authors":"Hermann O. Handwerker,&nbsp;Luis Garcia-Larrea","doi":"10.1002/ejp.2301","DOIUrl":"10.1002/ejp.2301","url":null,"abstract":"","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric examination of the Multidimensional Psychological Flexibility Inventory Short Form (MPFI-24) and the Psy-Flex Spanish versions in individuals with chronic pain.","authors":"Jaime Navarrete, Carla Rodríguez-Freire, Juan P Sanabria-Mazo, David Martínez-Rubio, Lance M McCracken, Ana Gallego, Felicia T A Sundstrom, Mayte Serrat, Jordi Alonso, Albert Feliu-Soler, Rubén Nieto, Juan V Luciano","doi":"10.1002/ejp.4704","DOIUrl":"https://doi.org/10.1002/ejp.4704","url":null,"abstract":"<p><strong>Background: </strong>Acceptance and Commitment Therapy (ACT) has been found to be beneficial for individuals dealing with chronic pain. The theoretical mechanisms of change proposed by ACT are based on the Hexaflex model. To comprehensively reflect this model, the Multidimensional Psychological Flexibility Inventory (MPFI) and Psy-Flex have been developed. The study aimed to adapt the MPFI-24 and the Psy-Flex for Spanish-speaking populations with chronic pain and to examine their dimensionality, internal consistency, convergent validity and incremental validity.</p><p><strong>Methods: </strong>This cross-sectional study involved 309 Spanish-speaking adults with chronic pain who completed an online survey. The majority of the participants were women (88.3%). The ages ranged from 18 to 79 years.</p><p><strong>Results: </strong>Factor analysis showed that the Spanish version of the MPFI-24 has 12 factors, consisting of six flexibility and six inflexibility factors, similar to the original version, but lacking second-order general factors. The Psy-Flex demonstrated a single-factor structure, maintaining the general factor of psychological flexibility seen in the original version. The MPFI-24 showed good internal consistency and adequate convergent validity, with the exception of the Acceptance and Experiential Avoidance subscales. The Psy-Flex showed good internal consistency and convergent validity. Notably, both the MPFI-24 and Psy-Flex scores significantly explained additional variance in psychological distress beyond other ACT-related measures of Hexaflex processes; however, only the Psy-Flex explained pain interference.</p><p><strong>Conclusions: </strong>The Spanish adaptations of the MPFI-24 and Psy-Flex are valid and reliable instruments for assessing the Hexaflex model processes in Spanish-speaking adults with chronic pain.</p><p><strong>Significance statement: </strong>Practitioners and researchers in chronic pain will find the Spanish versions of the MPFI-24 and the Psy-Flex here, along with recommendations for their use and scoring based on a robust psychometric rationale. It should be noted that these measures surpass the Chronic Pain Acceptance Questionnaire (CPAQ) and the Psychological Inflexibility in Pain Scale (PIPS), which are considered gold standards in chronic pain assessment.</p>","PeriodicalId":12021,"journal":{"name":"European Journal of Pain","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}