Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX, 78666, USA.
RestoreFX, Austin, TX, USA.
J Behav Med. 2022 Oct;45(5):739-749. doi: 10.1007/s10865-022-00347-w. Epub 2022 Aug 1.
Prescription-related opioid misuse, especially in chronic pain populations, is an ongoing problem and is related to increased mortality. The purpose of this study was to assess the utility of two restructured scales of the MMPI-2-RF: the Personality Psychopathology Five (PSY-5-RF) and the Higher-Order Scales to determine which of their subscales may be beneficial for identifying the risk of opioid misuse in a chronic pain population. A sample of 136 patients with chronic disabling occupational musculoskeletal disorders completed the MMPI-2-RF and the Current Opioid Misuse Measure (COMM) upon admission to a functional restoration program. The PSY-5-RF and H-O subscales were correlated with the baseline COMM scores. Correlation analyses, ROC curve analyses, and multiple binary logistic regression models were developed to determine which subscales were most associated with elevated COMM scores. The results of the regression analyses suggest that Scale elevations on two of the PSY-5-RF Scales and two Higher-Order Scales of the MMPI-2-RF demonstrated significant associations with elevated COMM scores, thus exhibiting the utility of these subscales in identifying the risk of opioid misuse among chronic pain patients. These findings are clinically meaningful in underscoring the importance of identifying specific personality traits as potential predictors of opioid misuse, and identifying those at risk through careful screening. Clinical implications based on each of the PSY-5-RF and H-O scales significantly associated with elevated COMM scores are discussed.
与处方相关的阿片类药物滥用，特别是在慢性疼痛人群中，是一个持续存在的问题，与死亡率增加有关。本研究的目的是评估 MMPI-2-RF 的两个重构量表的效用：人格心理病理学五（PSY-5-RF）和高阶量表，以确定它们的哪些分量表可能有助于识别慢性疼痛人群中阿片类药物滥用的风险。136 名患有慢性致残性职业肌肉骨骼疾病的患者在参加功能恢复计划时完成了 MMPI-2-RF 和当前阿片类药物滥用量表（COMM）。PSY-5-RF 和 H-O 分量表与基线 COMM 评分相关。进行了相关分析、ROC 曲线分析和多元二项逻辑回归模型，以确定哪些分量表与升高的 COMM 评分最相关。回归分析的结果表明，MMPI-2-RF 的两个 PSY-5-RF 量表和两个高阶量表的量表升高与升高的 COMM 评分显著相关，因此这些量表在识别慢性疼痛患者阿片类药物滥用风险方面具有实用性。这些发现具有重要的临床意义，强调了识别特定人格特征作为阿片类药物滥用潜在预测因素的重要性，并通过仔细筛查识别出那些处于风险中的人。根据与升高的 COMM 评分显著相关的 PSY-5-RF 和 H-O 量表中的每一个，讨论了临床意义。
