Assessing Psychological Flexibility and Inflexibility in Chronic Pain Using the Multidimensional Psychological Flexibility Inventory (MPFI)

• Published in: The journal of pain Vol. 24; no. 5; pp. 770 - 781
• Main Authors: Sundström, Felicia TA, Lavefjord, Amani, Buhrman, Monica, McCracken, Lance M
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2023
• Subjects: Acceptance and Commitment Therapy; Adaptation, Psychological; Adult; Chronic pain; Chronic Pain - psychology; disability; Humans; psychological flexibility; psychological inflexibility; psychological processes; Reproducibility of Results; Self Report; Surveys and Questionnaires; psychological flexibility; psychological inflexibility; disability; Chronic pain; psychological processes
• ISSN: 1526-5900; 1528-8447; 1528-8447
• DOI: 10.1016/j.jpain.2022.11.010

•An instrument is needed for capturing all facets of psychological flexibility and inflexibility.•The multidimensional psychological flexibility inventory(MPFI) is a measure assessing all facets of psychological flexibility and inflexibility.•The MPFI can be used in people with chronic pain where comprehensive assessment is needed.•Results here highlight that facets of psychological inflexibility correlate highly with outcomes. Psychological flexibility (PF) is a model of well-being and daily functioning that is applied to chronic pain, and is the model behind Acceptance and Commitment Therapy (ACT). However, studies of PF in chronic pain are limited by the lack of a single measure capturing all facets. The Multidimensional Psychological Flexibility Inventory (MPFI) assesses all facets of PF and psychological inflexibility (PI) and could remedy this problem. The current study employs this measure. Adult participants with chronic pain (N = 404) were recruited online and completed the MPFI, other validated measures of PF/PI, and measures of pain, work and social adjustment, and depression, at two time points. The reliability, factor structure, and validity of the MPFI were assessed. Confirmatory factor analysis results demonstrated a good model fit for the proposed factor-and subscale structure. Correlations between MPFI and theoretically similar measures were moderate to strong, and correlations with pain intensity, pain interference, work-and social adjustment, and depression, were small to large. In this first examination of the potential utility of the MPFI within a chronic pain population, we found it to be valid and reliable. It should be noted that the MPFI was less predictive of outcomes compared with more established measures in most cases. Despite this, results from the wide range of variables available from the MPFI highlights the potential importance of aspects of PF and PI not previously emphasized, including the greater predictive utility of the inflexibility facets. Further use and study of the MPFI is recommended. ClinicalTrials.gov ID: NCT05050565 This article presents a comprehensive examination of a self-report measure assessing all facets of psychological flexibility and inflexibility, in a chronic pain sample. The results support the role of facets not previously emphasized. Comprehensive assessment of PF and PI appears possible and is recommended depending on research questions being asked.