The heterogeneous pain personality: diverse coping styles among sufferers of chronic pain

The utility of personality assessment in chronic pain populations can be greatly enhanced with the understanding of risk assessment and the heterogeneous nature of at-risk personality types. Simplistic, unidimensional notions of risk have not been useful in assessing psychosocial and functional impairment in those with chronic pain syndromes. Previous literature suggests that certain combinations of psychometric scales, as opposed to individual scales, may be more useful in predicting the multiplicity of factors associated with functional disability among chronic pain patients. A hierarchical cluster analysis was performed on the 8 coping scales of the Millon Behavioral Health Inventory. Analyses revealed 3 distinct groups. The first cluster, termed repressors, exhibited high introversive and cooperative scales, and low forceful scales. The second cluster, termed amplifiers, exhibited high inhibited and sensitive scales. The third cluster, termed social copers, exhibited high confident and social scales. Analyses of these 3 clusters with regard to measures of psychopathology (Minnesota Multiphasic Personality Inventory II), depression (Beck Depression Inventory), functional impairment (Chronic Illness Problem Inventory), and other measures (Multidimensional Pain Inventory) resulted in significantly different levels of psychosocial and functional impairment. These clusters identified those patients who are at risk for nondisclosure of psychosocial dysfunction, those who are most emotionally distressed, and those who are most likely to comply with treatment. Consequently, such classifications identify psychosocial variables that will dictate a differential treatment approach and thus have potentially important clinical applications.