Rogers Andrew H, Gallagher Matthew W, Jamison Robert N, Zvolensky Michael J
Department of Psychology.
Texas Institute for Measurement, Evaluation, and Statistics.
Clin J Pain. 2020 Aug;36(8):578-583. doi: 10.1097/AJP.0000000000000846.
The opioid epidemic is a significant public health problem that is associated with overdose and death. The increase in opioid-related problems can largely be attributed to increases in opioid prescriptions for the treatment of chronic pain. Unfortunately, there is not a consensus on a definition of opioid misuse in the context of chronic pain, making measurement a challenge. One commonly used measure to assess opioid misuse in the context of chronic pain is the Current Opioid Misuse Measure (COMM). The COMM was designed to assess opioid misuse generally, as captured by psychiatric symptoms and aberrant drug use behaviors. Although studies have examined cross-validation using correlations, little psychometric work has been conducted, and therefore it is currently unknown what domains the measure is assessing.
The current study examined the factor structure of the COMM using confirmatory and exploratory factor analysis among 445 opioid-using adults with chronic pain.
The results did not support the widely accepted 1-factor opioid misuse solution; rather they supported a 2-factor, psychiatric problems and aberrant-drug-use-problems factor structure. Convergent and divergent validity were also examined at the bivariate level.
Given the importance and relevance for opioid misuse in the context of chronic pain, it is important for researchers to continue assessing and providing psychometric evidence for the COMM.
阿片类药物流行是一个重大的公共卫生问题,与过量用药和死亡相关。阿片类药物相关问题的增加在很大程度上可归因于用于治疗慢性疼痛的阿片类药物处方的增加。不幸的是,在慢性疼痛背景下,对于阿片类药物滥用的定义尚未达成共识,这使得测量成为一项挑战。一种常用于评估慢性疼痛背景下阿片类药物滥用的方法是当前阿片类药物滥用测量法(COMM)。COMM旨在总体评估阿片类药物滥用情况,通过精神症状和异常药物使用行为来体现。尽管已有研究通过相关性检验交叉验证,但很少进行心理测量学方面的工作,因此目前尚不清楚该测量法所评估的领域是什么。
本研究在445名患有慢性疼痛的阿片类药物使用者中,使用验证性和探索性因素分析来检验COMM的因素结构。
结果不支持广泛接受的单因素阿片类药物滥用解决方案;相反,它们支持一个双因素结构,即精神问题和异常药物使用问题因素结构。还在双变量水平上检验了聚合效度和区分效度。
鉴于在慢性疼痛背景下阿片类药物滥用的重要性和相关性,研究人员继续评估COMM并提供心理测量学证据非常重要。