Does Personality Pathology Incrementally Predict Pain Perceptions beyond Overdependence?

Hunt MS/MA, Lindsey, Rachel Pad BGS, and Steven Huprich PhD

In an earlier study, Huprich, Hoban, Boys, and Rosen (2013) reported that destructive overdependence was strongly associated with scores on the Multidimensional Pain Inventory (MPI; Kerns, Turk, & Rudy, 1985).  Specifically the Interference, Pain Severity, Affective Distress, and Support scales were all positively correlated with Destructive Overdependence scale of the Relationship Profile Test (RPT; Bornstein & Languirand, 2003) in a sample of 98 outpatients receiving physical therapy.  In the current study, we considered the collective contribution of destructive overdependence and personality pathology in predicting MPI scale scores. Patients were assessed with self-reported personality disorder symptoms for Clusters B and C on the Structured Clinical Interview for DSM-IV Axis II Disorders – Self Report (First, Gibbon, Spitzer, Williams, & Benjamin, 1997), along with the RPT and MPI. Imputation was used to replace missing data. We found that the Interference scale of the MPI was uniquely predicted by the composite score of Cluster B and C symptoms above and beyond Destructive Overdependence. Whereas, Destructive Overdependence continued to uniquely predict the Support scale. Additionally, the Self Control and the Affective Distress scales of the MPI were no longer predicted by Destructive Overdependence when the Cluster B and C symptom total was included. Finally, Cluster B and C symptom total uniquely predicted Punishing Responses on the MPI. It is concluded that personality pathology has important relationships to the subjective perceptions of pain and ought to be considered as part of an assessment of patients’ pain experience.  Furthermore, these findings demonstrate how personality disorder symptoms are associated with levels of functioning, which is consistent with Section III DSM-5 assessment of personality pathology.