The complexity of chronic pain has represented a major dilemma for clinical researchers interested in the reliable and valid assessment of the problem and the evaluation of treatment approaches. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI) was developed in order to fill a widely recognized void in the assessment of clinical pain. Assets of the inventory are its brevity and clarity, its foundation in contemporary psychological theory, its multidimensional focus, and its strong psychometric properties. Three parts of the inventory, comprised of 12 scales, examine the impact of pain on the patients' lives, the responses of others to the patients' communications of pain, and the extent to which patients participate in common daily activities. The instrument is recommended for use in conjunction with behavioral and psychophysiological assessment strategies in the evaluation of chronic pain patients in clinical settings. The utility of the WHYMPI in empirical investigations of chronic pain is also discussed.
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... West Haven-Yale Multidimensional Pain Inventory (WHYMPI) is one of the most commonly used multi -dimensional scale for chronic pain in terms of physiologic, psychologic and emotion aspects. 6 The impact of pain on daily life, the individual's degree of participation in the activities and the individual's surroundings expression of pain are evaluated in the scale which has been translated into various languages and it is used to assess a wide range of pathologies. ...
... The third section evaluates the patient's activity and frequency of activity. 6 . Distribution according to the subtitle and scoring of the items in WHYMPI are shown in Table 1. ...
... for assessing chronic pain is a great role nowadays. 6 WHYMPI-T that is the multidimensional pain scale is a valid and reliable scale for patients with chronic low back pain as a result of the study. ...
Background: West Haven-Yale Multidimensional Pain Inventory (WHYMPI), used in the evaluation of patients with chronic pain including behavioral and cognitive assessment, is a multidimensional pain scale consisting of three main sections and 12 subscales. The validity of this inventory has been supported by various study results of confirmatory and exploratory factor analytic procedures. The aim of our present study was to investigate the validity and reliability of the Turkish form of the West Haven-Yale Multidimensional Pain Inventory (WHYMPI-T). Methodology: 41 patients, with a minimum 3 mon history for chronic non-specific low back pain, without previous surgical history, neurological and rheumatic diseases, and without communication problem; completed Brief Pain Inventory (BPI), McGill Pain Questionnaire (MPQ), Beck Depression Inventory (BDI) and the Short Form-36 (SF-36) scales. The measurements were repeated in fifth days. Results: Significant difference between WHYMPI-T lower and upper group averages was found. Internal consistency analysis of the scale, Cronbach's α coefficient ranged from 0.93 to 0.99 for B and C sections. All the items of A, B and C sections were found compatible with each other in the item analyses and scale test-retest results were congruent with each other. Between WHYMPI-T subscales and BPI, MPQ, BDI, SF-36 scales, a positive correlation was observed. Conclusion: The results of our study confirm that WHYMPI-T is a valid and reliable instrument which can be used for the evaluation of chronic non-specific low back pain.
... Firstly, they mainly focus on partner´s responsiveness and solicitousness (e.g., providing pain medication, helping with chores, asking how they can help) (Newton-John, 2002), which are not necessarily validation. Also, studies have used social support measures as a proxy to validation, when in fact they measure distraction and problem-solving behaviors [e.g. the support subscale of the Multidimensional Pain Inventory (MPI; Kerns et al., 1985)], and/or satisfaction with support [the Social support in Pain Questionnaire (SPQ;Lugt et al., 2011)] rather than validation. Additionally, many studies have used observational coding systems (e.g., Cano et al., 2008;Edmund and Keefe, 2015;Leong et al., 2011), which tell us little about the subjective experience of being validated. ...
... (e.g., Burns et al., 2018), which may fail to grasp such a complex construct as criticism. Some studies overcome this limitation of 1-item measures by using the punishing responses subscale of the MPI, which measures some aspects of criticism, such as anger, irritation, frustration, and ignoring (Kerns et al., 1985), but not necessarily the nuances of criticism [dismissiveness, put-down, comparative criticism, and shaming behaviors (e.g.,Gilbert ...
Background: Research suggests that the way others react to a pain flare-up impacts
on psychological and pain-related symptoms in chronic pain(CP). Experiencing
validation from others is associated with less negative emotions and better functioning.
Contrarily, experiencing criticism is linked to greater pain intensity and worse
functioning. Nonetheless, studies are limited by an exclusive focus on spouses rather
than significant other relationships, the use of proxy constructs (e.g.,social support,
responsiveness, solicitousness) rather than specific measures of validation and
criticism, and a focus on significant others behavior rather than patients subjective
experience. This study examines the psychometric properties of a new measure-
Perceived Validation and Criticism in Pain Questionnaire(PVCPQ), and tests its
contribution to functional impairment beyond pain intensity, sociodemographic and
medical-related variables, positive and negative affect, safeness, and compassion from
Methods: Women with CP(N=172), 130 (75.6%) of whom had fibromyalgia, completed
an online battery of questionnaires (PVCPQ; numeric pain rating scale; work and social
adjustment scale; positive and negative affect schedule; social and pleasure scale;
compassionate engagement and action scale). Exploratory factor analysis(EFA),
reliability, correlational and hierarchical regression analyses were performed.
Results: EFA showed a 23-item two-factor solution with good psychometric properties.
Criticism in pain (but not validation in pain) contributed to functional impairment
beyond the variance explained by pain intensity, sociodemographic and medical
variables, positive and negative affect, safeness and compassion from others.
Conclusions: These findings suggest that the PVCPQ is a psychometrically valid new
measure of perceived validation and criticism in pain that contributes to explaining
pain-related functional impairment
... All participants were asked to complete a series of questionnaires. The outcomes that were reported by the participants and used in analyses are shown in Table 1 . Six questionnaires were completed on a daily basis, of which the mean of all days was calculated and included in the analysis. ...
... Pain intensity was rated with an 11-point rating scale from 0 to 10 to assess the worst, least, average and current pain experienced during the last week. Pain-associated disability was assessed with the corresponding subscale of the Multidimensional Pain Inventory (MPI) based on 10 items rated from 0 to 6 (Flor et al., 1990;Kerns et al., 1985) and reached excellent reliability (T0: ω=0.98; T1: ω=0.98). ...
Background: Major Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depression in the occupational group of green professions.
Methods: This two-armed pragmatic RCT (n = 360) evaluates the effectiveness of a tailored internet-based intervention (IMI) program compared to enhanced treatment as usual. The IMI program entailed access to one of six guided IMIs each focusing on different symptom areas (depressive mood with optional comorbid diabetes, perceived stress, insomnia, panic and agoraphobia and harmful alcohol consumption). Eligible were entrepreneurs, spouses, family members and pensioners in green professions with adequate insurance status and at least subthreshold depression (PHQ≥5). Primary outcome was depressive symptom severity (QIDS-SR16) at 9-weeks post-treatment (T1). Various secondary outcomes were assessed at T1.
Results: A small effect of depression reduction (d=-0.28, 95%-CI: -0.50 to -0.07) was found at T1 favouring the IMI program (β=-0.22, 95%-CI: -0.41 to -0.02, p=.033). Categorical analysis indicated a reduced risk of potential MDD with NNTB=28.11. Adherence to the IMI program at T1 was exceptionally low.
Limitations: Results are limited to green professions and representativeness might be restricted by self-selection of participants.
Conclusion: Depression burden in green professions can be reduced by this online prevention measure. Yet, short-term effectiveness is restricted by low adherence rates.
German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.
Full text available: https://authors.elsevier.com/a/1c2o-bXYig%7EEw
... The West Haven-Yale Multidimensional Pain Inventory (WHYMPI): WHYMPI is a self-administered self-report of chronic pain behaviour assessing the entire range of psychosocial effects in chronic pain patients . ...
... 28 Research supports a unitary construct of pain severity, as strong correlations between measures of pain intensity and measures of pain disability have been demonstrated. 32,33 The BPS variable was independent variable in the regression analysis. To test the interaction effect between pain and depression or anxiety, a graded pain variable with 3 different levels was computed: high level of pain (0-30), medium level of pain , and low level of pain (71-100). ...
... It is applicable to a wide range of health conditions and treatments and it provides a single index value for health status (where a score of 1 represents "perfect health" and values below 0 represent states "worse than death") that can be used in clinical and economic evaluations of health care as well as in population health surveys . Further, and more specific to the experience of chronic pain, dimensions of pain intensity, emotional distress, cognitive and functional adaptation, and social support were assessed using the Multidimensional Pain Inventory (MPI) . In accordance with the procedure described by McKillop et al., two summary scores were used for the presentation of domain impairment and social support, MPI impairment (0-6, where high scores represent high perceived impairment) and MPI social support (0-6, where high scores represent high social support) . ...
Chronic pain is a leading cause of disability globally. Interdisciplinary multimodal pain rehabilitation (IMPR) targets pain with a bio-psycho-social approach, often delivered as composite programs. However, evidence of optimal program duration for the rehabilitation to succeed remains scarce. This study evaluated the effectiveness of different duration IMPR-programs—using within- and between-effects analyses in a pragmatic multicenter register-based controlled design. Using the Swedish Quality Registry for Pain Rehabilitation, data from fifteen clinics specialized in chronic pain rehabilitation across Sweden were retrieved. Participants were patients with chronic musculoskeletal pain who had taken part in short (4–9 weeks; n = 924), moderate (10 weeks; n = 1379), or long (11–18 weeks; n = 395) IMPR programs. Longitudinal patient-reported outcome data were assessed at baseline, post-intervention, and at a 12-month follow-up. Primary outcomes were health-related quality of life, presented as perceived physical and mental health (SF-36). Secondary outcomes included the Hospital Anxiety and Depression Scale (HADS), pain intensity (NRS 0-10), the Multidimensional Pain Inventory (MPI), and perceived health (EQ-5D). Overall, all groups showed improvements. No clinically important effect emerged for different duration IMPR. In conclusion, while our results showed that patients following IMPR report improvement across a bio-psycho-social specter, a longer program duration was no more effective than a shorter one.
Chronic pain is highly prevalent, associated with substantial personal and economic burdens, and increased risk for mental disorders. Individuals in green professions (agriculturists, horticulturists, foresters) show increased prevalence of chronic pain and other risk factors for mental disorders. Available healthcare services in rural areas are limited. Acceptance towards face-to-face therapy is low. Internet and mobile-based interventions (IMIs) based on Acceptance and Commitment Therapy (ACT) might be a promising alternative for this population and may enable effective treatment of chronic pain. The present study aims to evaluate the clinical and cost-effectiveness of an ACT-based IMI for chronic pain in green professions in comparison with enhanced treatment as usual (TAU+).
Methods and analysis:
A two-armed pragmatic randomised controlled trial will be conducted. Two hundred eighty-six participants will be randomised and allocated to either an intervention or TAU+ group. Entrepreneurs in green professions, collaborating spouses, family members and pensioners with chronic pain are eligible for inclusion. The intervention group receives an internet-based intervention based on ACT (7 modules, over 7 weeks) guided by a trained e-coach to support adherence (eg, by positive reinforcement). Primary outcome is pain interference (Multidimensional Pain Interference scale; MPI) at 9 weeks post-randomisation. Secondary outcomes are depression severity (Quick Inventory Depressive Symptomology; QIDS-SR16), incidence of major depressive disorder, quality of life (Assessment of Quality of Life; AQoL-8D) and possible side effects associated with the treatment (Inventory for the Assessment of Negative Effects of Psychotherapy; INEP). Psychological flexibility (Chronic Pain Acceptance Questionnaire, Committed Action Questionnaire, Cognitive Fusion Questionnaire) will be evaluated as a potential mediator of the treatment effect. Furthermore, mediation, moderation and health-economic analyses from a societal perspective will be performed. Outcomes will be measured using online self-report questionnaires at baseline, 9-week, 6-month, 12-month, 24-month and 36-month follow-ups.
Ethics and dissemination:
This study was approved by the Ethics Committee of the University of Ulm, Germany (file no. 453/17-FSt/Sta; 22 February 2018). Results will be submitted for publication in peer-reviewed journals and presented at conferences.
Trial registration number:
German Clinical Trial Registration: DRKS00014619. Registered on 16 April 2018.
Chronic opioid use may lead to adrenal insufficiency due to central suppression of the hypothalamic-pituitary-adrenal axis. However, the prevalence of opioid induced adrenal insufficiency (OIAI) is unclear.
To determine the prevalence of OIAI, and to identify predictors for the development of OIAI in patients taking opioids for chronic pain.
Cross-sectional study, 2016-2018
Adult patients taking chronic opioids admitted to the Pain Rehabilitation Center
Main outcome measure
Diagnosis of OIAI was considered if positive case detection (cortisol&10 mcg/dl, ACTH&15 pg/ml, and Dehydroepiandrosterone sulfate (DHEAS)&25 mcg/dL), and confirmed after endocrine evaluation. Daily morphine milligram equivalent (MME) was calculated.
In 102 patients (median age 53 years (range 22-83), 67% women), median daily MME was 60 mg (3-840), and median opioid therapy duration was 60 months (3-360). Abnormal case detection testing was found in 11 (10.8%) patients, and diagnosis of OIAI was made in 9 (9%). Patients with OIAI were on a higher daily MME (median 140 (20-392) mg vs 57 (3-840) mg, p=0.1), and demonstrated a 4 times higher cumulative opioid exposure (median of 13440 vs 3120 mg*months, p=0.03). No patient taking &MME of 20 mg/day developed OIAI (sensitivity of 100% for MME>20 mg), however specificity of MME cutoff >20 mg was only 19%. After opioid discontinuation, 6/7 patients recovered adrenal function.
The prevalence of OIAI was 9%, with MME cumulative exposure being the only predictor for OIAI development. Patients on MME of 20 mg/day and above should be monitored for OIAI.
Vulvodynia is a prevalent condition associated with significant and negative effects across many areas of functioning. This chapter focuses on self‐report measures, which are critical assessment tools: the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). It provides several suggestions that can serve as a starting point to create a validating context for a patient with vulvodynia. The overall approach will serve to create a comfortable atmosphere for a thorough pain assessment, starting with the history of the pain and its functional effects. Validated self‐report questionnaires can be used to further assess any of the domains and to track progress, depending on the established treatment goals. In terms of specific aspects of the pain experience, IMMPACT recommends assessing intensity, quality, and affect, temporal pattern, and the use of “rescue” analgesics.
Relationships among measures of pain intensity, depressed mood, marital satisfaction, and spouse supportiveness were studied in a sample of 30 male, chronic pain patients and their wives. Over one-half of the patients and spouses reported significant depression and marital dissatisfaction. The lack of significant relationship between pain intensity and either depression or marital satisfaction, and the presence of significant correlations between depression and spouse-support measures was interpreted as support for a multidimensional, cognitive-behavioral model of depression among chronic pain patients.
The science of politics is a science of human behavior. It concerns itself with a specific segment of the activities of humans—those which either take place in, or have a clearly discernible effect upon, the formal governmental machinery of the community. The characteristic feature of a political scientist, therefore, is not his unique theoretical framework but his special empirical interest. Two main consequences follow. First, it is trivially true, and widely recognized, that the major concepts of other behavior sciences are necessarily an integral part of the study of political behavior. Second, it is equally true that, within the social sciences, it is the responsibility of political science to develop those elements of behavior theory that are particularly relevant for the analysis of action in the sphere of politics.
Much of current empirical and theoretical work in political analysis is organized around the observation that many political data can be conceived to represent results of mechanisms for decision-making used (consciously or unconsciously) by individuals or collectivities. In a similar fashion, students of a significant number of other types of behavior have tended to formulate their problems within a decision-making framework. When one examines these apparently disparate branches of behavior theory, it is difficult to avoid the conclusion that there exist potentially fruitful parallelisms among such theories as those of consumer behavior, administrative behavior, price setting, legislative enactments, propaganda, learning, foreign affairs, and social control.
The purpose of this study was to determine the underlying factor structure of the WPPSI-R. Previous factor analyses of the WPPSI generally have supported a two-factor interpretation. Three separate maximum likelihood confirmatory factor analyses were performed on the WPPSI-R standardization sample (N = 1,700). A one-factor (general), a two-factor (verbal and performance), and a three-factor solution were imposed on the median intercorrelation matrix of the 12 WPPSI-R subtests. A comparison of underlying theory and goodness-of-fit statistics for the three analyses provided support for the two-factor solution as best representing the underlying structure of the WPPSI-R. The verbal and performance factors correlated highly, which indicates an underlying general component. The results lend continued support for the interpretation of separate Verbal and Performance Scales and for the interpretation of a Full Scale Score.
Reviews methodologies used in the measurement of pain. To assess the measurement strategies currently used by behavior therapists, 5 journals were surveyed for the years 1973–1975. Four specific suggestions are offered for behavior therapists to improve their strategies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)