Wolf Erika J, Higgins Diana M, Zhao Xiang, Hawn Sage E, Sanborn Victoria, Todd Catherine A, Fein-Schaffer Dana, Houranieh Antoun, Miller Mark W
National Center for PTSD at VA Boston Healthcare System, Boston, USA.
Department of Psychiatry, Boston University Chobanian and Avedisian School of Medicine, Boston, USA.
J Clin Psychol Med Settings. 2024 Mar;31(1):58-76. doi: 10.1007/s10880-023-09967-z. Epub 2023 Jul 7.
Chronic pain is a debilitating condition for many military Veterans and is associated with posttraumatic stress disorder (PTSD). This study examined the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in 144 Veterans (88.2% male, mean age = 57.95 years) recruited from a VA outpatient pain clinic and associations with self-reported pain severity, pain-related interference in daily activities, prescription opioid use, and objective metrics of physical performance on tasks impacted by pain (walking, stair climbing, grip strength, indexed by a single latent variable). Among the cohort with valid responses on the MMPI-2-RF (n = 117) and probable PTSD, mean Somatic Complaints (RC1) and Ideas of Persecution (RC6) scores were clinically elevated. All MMPI-2-RF scales were more strongly correlated with self-reported pain interference than severity. Regressions revealed associations between self-rated pain interference (but not pain or PTSD severity) and physical performance scores (β = .36, p = .001). MMPI-2-RF overreporting Validity and Higher-Order scales contributed incremental variance in predicting physical performance, including Infrequent Psychopathology Responses (β = .33, p = .002). PTSD severity was associated with prescription opioid use when accounting for the effects of over-reported somatic and cognitive symptoms (odds ratio 1.05, p ≤ .025). Results highlight the role of symptom overreporting and perceptions of functional impairment to observable behaviors among individuals with chronic pain.
慢性疼痛对许多退伍军人来说是一种使人衰弱的疾病，并且与创伤后应激障碍（PTSD）相关。本研究对从退伍军人事务部（VA）门诊疼痛诊所招募的144名退伍军人（88.2%为男性，平均年龄=57.95岁）进行了明尼苏达多相人格调查表第二版修订版（MMPI-2-RF）测试，并研究了其与自我报告的疼痛严重程度、疼痛对日常活动的干扰、处方阿片类药物使用以及疼痛影响的任务（行走、爬楼梯、握力，由一个单一潜在变量表示）的身体表现客观指标之间的关联。在对MMPI-2-RF有有效回答（n = 117）且可能患有PTSD的队列中，躯体主诉（RC1）和被害观念（RC6）的平均得分在临床上有所升高。所有MMPI-2-RF量表与自我报告的疼痛干扰的相关性都比与疼痛严重程度的相关性更强。回归分析显示，自我评定的疼痛干扰（而非疼痛或PTSD严重程度）与身体表现得分之间存在关联（β = 0.36，p = 0.001）。MMPI-2-RF的过度报告效度和高阶量表在预测身体表现方面贡献了额外的方差，包括罕见精神病理学反应（β = 0.33，p = 0.002）。在考虑过度报告的躯体和认知症状的影响时，PTSD严重程度与处方阿片类药物使用相关（优势比1.05，p≤0.025）。结果突出了症状过度报告以及功能损害认知对慢性疼痛个体可观察行为的作用。
