Cipher Daisha J, Clifford P Andrew, Schumacker Randall E
University of North Texas Health Science Center, Fort Worth, USA.
Altern Ther Health Med. 2002 Nov-Dec;8(6):60-9.
The utility of personality assessment in chronic pain populations can be greatly enhanced with the understanding of risk assessment and the heterogeneous nature of at-risk personality types. Simplistic, unidimensional notions of risk have not been useful in assessing psychosocial and functional impairment in those with chronic pain syndromes. Previous literature suggests that certain combinations of psychometric scales, as opposed to individual scales, may be more useful in predicting the multiplicity of factors associated with functional disability among chronic pain patients. A hierarchical cluster analysis was performed on the 8 coping scales of the Millon Behavioral Health Inventory. Analyses revealed 3 distinct groups. The first cluster, termed repressors, exhibited high introversive and cooperative scales, and low forceful scales. The second cluster, termed amplifiers, exhibited high inhibited and sensitive scales. The third cluster, termed social copers, exhibited high confident and social scales. Analyses of these 3 clusters with regard to measures of psychopathology (Minnesota Multiphasic Personality Inventory II), depression (Beck Depression Inventory), functional impairment (Chronic Illness Problem Inventory), and other measures (Multidimensional Pain Inventory) resulted in significantly different levels of psychosocial and functional impairment. These clusters identified those patients who are at risk for nondisclosure of psychosocial dysfunction, those who are most emotionally distressed, and those who are most likely to comply with treatment. Consequently, such classifications identify psychosocial variables that will dictate a differential treatment approach and thus have potentially important clinical applications.
通过理解风险评估以及高危人格类型的异质性，人格评估在慢性疼痛人群中的效用可得到极大提升。简单、一维的风险观念在评估慢性疼痛综合征患者的心理社会和功能损害方面并无用处。先前的文献表明，某些心理测量量表的组合，而非单个量表，可能在预测慢性疼痛患者中与功能残疾相关的多种因素方面更有用。对米隆行为健康量表的8个应对量表进行了层次聚类分析。分析揭示了3个不同的组。第一组称为压抑者，表现出高内向和合作量表得分，以及低强制量表得分。第二组称为放大者，表现出高抑制和敏感量表得分。第三组称为社会应对者，表现出高自信和社交量表得分。对这3组在心理病理学测量（明尼苏达多相人格调查表第二版）、抑郁（贝克抑郁量表）、功能损害（慢性病问题量表）和其他测量（多维疼痛量表）方面的分析，得出了心理社会和功能损害水平的显著差异。这些聚类确定了那些有心理社会功能障碍不披露风险的患者、那些情绪困扰最严重的患者以及那些最有可能遵守治疗的患者。因此，这样的分类确定了将决定不同治疗方法的心理社会变量，因而具有潜在重要的临床应用价值。
