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A shorter MPFI designed specifically for patients with chronic pain proved generally valid and reliable on a group level, according to a recent study.
A short-form version of the Multidimensional Psychological Flexibility Inventory (MPFI) designed specifically for patients with chronic pain proved generally valid and reliable on a group level, according to a study in the European Journal of Pain.
The 60-item MPFI was introduced in 2018 to gauge psychological flexibility and inflexibility and to identify areas meriting intervention, explained corresponding author Amani Lavefjord and study coauthors.
Facets of psychological flexibility include acceptance, defusion, self-as-context, awareness of the present moment, values, and committed action. Psychological inflexibility includes experiential avoidance, fusion, self-as-content, lack of awareness of the present moment, lack of connection to values, and inaction.
Because psychological flexibility is important in the treatment of patients with chronic pain, and the full-length MPFI is lengthy in some contexts, the research team created a short-form MPFI (MPFI-24P) for patients.
They recruited 404 adults with chronic pain through patient organizations and social media. Patients answered background questions and completed the MPFI and the Brief Pain Inventory pain interference (BPI-PI) subscale, the Work and Social Adjustment Scale (WSAS), and the Patient Health Questionnaire (PHQ-9).
The resulting MPFI-24P includes 12 items measuring flexibility and 12 items measuring inflexibility that were selected using item response theory and confirmatory factor analysis.
“We note that correlation and regression results for the MPFI-24P global scales in relation to the outcomes measured by BPI-PI, WSAS, and PHQ-9 closely resembled results from the full-length global scales and outcomes,” the researchers reported. “This highlights the practical utility of the shorter measure.”
The inflexibility scales on the MPFI-24P tended to predict outcomes better than the flexibility scales. However, the same is true for the full-length MPFI.
“In the flexibility scale, items measuring self-as-context, values, and committed action did not measure the higher ends of psychological flexibility. Clinicians should keep in mind that a person selecting a middle response option on these items may be presenting with less than average levels,” the researchers advised.
The team suggested the MPFI-24P be considered a starting point for future refinement and potential adaptations for patients.
“This approach is highly recommended given the wider purposes connected to the flexibility/inflexibility model,” the researchers wrote, “including better treatment results.”
