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Rehab Measures: West-Haven-Yale Multidimensional Pain Inventory

Link to instrument

Find it on the Transport Accident Commission (TAC) Website 

Title of Assessment

West-Haven-Yale Multidimensional Pain Inventory 

Acronym

WHYMPI

Instrument Reviewer(s)

 

Summary Date

 

Purpose

  • Recommended for use in conjunction with behavioral and psycho-physiological strategies
  • Assesses chronic pain.in individuals

Description

The WHYMPI is based on a cognitive-behavioral theory of pain emphasizing the role of cognitive, emotional, and behavioral factors in the  experience of pain and related disability
The MPI is composed of 61 items across three domains.
 
The first domain assess patient life factors
    • The first domain assesses the Impact of pain in the patients' life (3 items)
    • The amount of interference pain had on the patients' life (9 items)
    • The patients' perceptions of control over their lives (2 items)
    • Patients' level of affective distress (3 items)
    • Patients' perceptions of support received by significant others (3 items)
The second domain assesses the responses of others to the patient's pain:
    • The patients' perceptions of how significant others react to their pain (4 items)
    • Solicitious Responses (4 items)
    • Distracting responses (6 items)
The third domain assesses the extent to which patients participate in daily activities
    • The performance of Household chores (5 items)
    • Ability to preform Outdoor work (5 items)
    • Activities away from home (4 items)
    • Social activities (4 items)

Area of Assessment

Pain 

Body Part

Neck; Upper Extremity; Back; Lower Extremity 

ICF Domain

Body Function 

Domain

Sensory 

Assessment Type

Patient Reported Outcomes 

Length of Test

31 to 60 Minutes 

Time to Administer

30 to 60 minutes

Number of Items

61 

Equipment Required

None

Training Required

None

Type of training required

No Training 

Cost

Free 

Actual Cost

Free

Age Range

Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Arthritis; Fibromyalgia; Geriatrics; Hip Fracture; Multiple Sclerosis; Neck injury; Pain; Spinal Cord Injury; Stroke; Traumatic Brain Injury 

Populations Tested

  • Headache
  • Fibromyalgia syndrome
  • Pain associated with cancer
  • Systemic lupus erythematosus
  • Chronic pelvic pain
  • Phantom limb pain
  • Whiplash disorders

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Chronic Pain Patients: (Kerns et al, 1985; n = 120; mean age = 50.8 (14.5) years; mean duration to pain = 10.2 years; 36.4% reported lower back pain)
 
WHYMPI Normative Data:
Domain

Mean (SD)

Interference
3.74 (1.26)
Support
4.31 (1.47)
Pain Severity
3.55 (1.11)
Self-control
3.63 (1.57)
Negative Mood
3.23 (1.32)
Punishing response
0.97 (0.94)
Solicitious response
2.57 (1.15)
Distracting responses
1.72 (1.31)
Household chores
2.71 (1.30)
Outdoor work
1.19 (1.04)
Activities away from home
1.79 (0.83)
Social activities
1.94 (0.95)

Test-retest Reliability

Inpatient Sample: (Broderick et al, 2004; n = 199; mean age approximately 50 (11) years; interval between the two samples examined was significantly different (treatment sample = 19.4 days versus 33.7 days for the mail sample)
 
Test-retest Reliability Between Two Validation Studies:
MPI Scales

Correlation coefficients

Broderick: means (SDs)

Strenght
Broderick (2004)
Strenght
Kerns (1985)
First assessment
Second assessment
Pain severity

Excellent

0.74

Excellent

0.82
43.4 (10.9)
42.3 (11.6)
Interference

Excellent

0.87

Excellent

0.86
43.1 (11.6)
41.6 (11.8)
Life control

Excellent

0.62

Excellent

0.68
49.2 (7.1)
49.0 (7.4)
Affective distress

Adequate

0.53

Excellent

0.69
47.1 (9.5)
46.9 (10.5)
Support

Excellent

0.84

Excellent

0.80
43.2 (11.3)
42.2 (11.3)
Punishing responses

Excellent

0.79

Excellent

0.84
49.9 (9.2)
50.5 (9.3)
Solicitous responses

Excellent

0.83

Excellent

0.89
47.2 (10.2)
46.9 (9.8)
Distracting responses

Excellent

0.80

Excellent

0.62
47.9 (9.6)
47.0 (9.4)
Household chores

Excellent

0.80

Excellent

0.91
57.2 (7.4)
57.1 (7.5)
Outdoor work

Excellent

0.70

Excellent

0.83
50.6 (9.8)
51.3 (9.5)
Activities away from home

Excellent

0.83

Excellent

0.88
55.6 (10.0)
54.9 (9.6)
All correlations significant at p < 0.001
 
Chronic Musculoskeletal Pain: (Bergstrom et al, 1998; n = 54 for test-retest correlation, mean age = 41.8 (9.4), duration of pain = 67.9 (70.4) months, Swedish sample)
 
Test-retest Data:
Scale
Number of items
Mean (SD)
Strength
Test-retest ICC
Pain Severity
2
3.73 (1.16)

Excellent

0.75
Interference
11
3.74 (1.08)

Excellent

0.85
Life Control
4
3.12 (1.16)

Excellent

0.81
Affective Distress
3
2.95 (1.49)

Adequate

0.74
Support
2
4.30 (1.57)

Excellent

0.88
Punishing Responses
3
1.23 (1.29)

Excellent

0.75
Solicitous Responses
6
2.95 (1.35)

Adequate

0.73
Distracting Responses
3
3.14 (1.60)

Excellent

0.76
Household Chores
5
3.58 (1.39)

Excellent

0.89
Outdoor Work
3
1.68 (1.46)

Excellent

0.86
Leisure Activities
5
3.08 (1.18)

Excellent

0.79
General Activity

13

2.97 (0.89)

Excellent

0.80

Interrater/Intrarater Reliability

Chronic Pain Patients: (Kerns et al, 1985; n = 60, 2 weeks between assessments)
 
WHYMPI Intra-rater Reliability:
Domain Strength

Stability

Interference

Excellent

0.86
Support

Excellent

0.80
Pain Severity

Excellent

0.82
Self-control

Adequate

0.68
Negative Mood

Adequate

0.69
Punishing response

Excellent

0.84
Solicitious response

Excellent

0.89

Distracting responses

Adequate

0.62
Household chores

Excellent

0.91
Outdoor work

Excellent

0.83
Activities away from home

Excellent

0.88
Social activities

Excellent

0.87

Internal Consistency

Chronic Musculoskeletal Pain: (Bergstrom et al, 1998; n = 682; mean age = 41.8 (9.4); duration of pain = 67.9 (70.4) months; Swedish sample)
 
Internal Consistency:
Scale
number of items
mean (SD)

Strength

Chronbach's alpha
Pain Severity
2
3.73 (1.16)

Excellent

0.80
Interference
11
3.74 (1.08)

Excellent

0.86
Life Control
4
3.12 (1.16)

Poor

0.66
Affective Distress
3
2.95 (1.49)

Excellent

0.80
Support
2
4.30 (1.57)

Excellent

0.81
Punishing Responses
3
1.23 (1.29)

Excellent

0.86
Solicitous Responses
6
2.95 (1.35)

Adequate

0.77
Distracting Responses
3
3.14 (1.60)

Adequate

0.76
Household Chores
5
3.58 (1.39)

Excellent

0.81
Outdoor Work
3
1.68 (1.46)

Excellent

0.80
Leisure Activities
5
3.08 (1.18)

Poor

0.67
General Activity

13

2.97 (0.89)

Adequate

0.74

 
 
Temporomandibular Disorder: (Andreu et al, 2006; n = 114, mean age = 35 (14) years)
 
Domain level Internal Consistency:
Section
Domain

Strength

Chrnobach's alpha
Section 1
Repercussion of pain

Excellent

0.85
Social support

Excellent

0.82
Pain severity

Adequate

0.75
Negative mood

Adequate

0.75
Interference in daily activities

--

--
Section 2
Negative responses

Adequate

0.78
Support responses

Excellent

0.85
Section 3 Household chores

Excellent

0.80

Social and leisure activities

Adequate

0.73

Taking care of the car

Excellent

0.88

Criterion Validity (Predictive/Concurrent)

Fibromyalgia: (Turk and Rudy, 1988; n = 48) Three subtypes based on WHYMPI scores were created; these include:
  • Dysfunctional (DYS)
  • Interpersonally Distressed (ID)
  • Adaptive Copers (AC)
6 treatment sessions spaced over 4 weeks resulted in significantly different levels of functioning.  DYS patients experienced reductions in pain, affective distress and perceived interference of pain while ID patients exhibited poor responses to treatment.  AC patients demonstrated reductions in pain, but not affective distress or disability.

Construct Validity (Convergent/Discriminant)

Chronic Pain Patients: (Kerns et al, 1985)
Construct validity of the WHYMPI was assessed with factor analysis with commonly utilized scales including:
  • The McGill Pain Questionnaire (MPQ)
  • The Beck Depression Inventory (BDI)
  • The Depression Adjective Check List (DACL)
  • The State-Trait Anxiety Inventory-State form (STAI-S)
  • The Multidimensional Health Locus of Control Scale (MHLC)
  • The Marital Adjustment Scale (MAS)
Results found that items correlated significantly with hypothesized factors, providing supporting evidence of convergent validity.

Content Validity

Chronic Pain Patients: (Kerns et al, 1985; from the original validation study)
Three separate sections of the West Haven-Yale Multidimensional Pain Inventory, WHYMPI) were created.
  • The first section is the most comprehensive focusing on the evaluation of perceived pain intensity and the impact of that pain on aspects of the daily life.
  • The second section is designed to evaluate a patients’ perception of their significant other's response to the communication of pain.
  • The third section of the WHYMPI assesses the frequency of a patients’ performance of common activities.

Face Validity

Not Assessed

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established

Professional Association Recommendations

 

Considerations

Translated into several languages:
  • Spanish
  • German
  • Dutch
  • Swedish
  • Italian

Bibliography

Andreu, Y., Galdon, M. J., et al. (2006). "An examination of the psychometric structure of the Multidimensional Pain Inventory in temporomandibular disorder patients: a confirmatory factor analysis." Head Face Med 2: 48. Find it on PubMed

Bergstrom, K. G., Jensen, I. B., et al. (1999). "A psychometric evaluation of the Swedish version of the Multidimensional Pain Inventory (MPI-S): a gender differentiated evaluation." Eur J Pain 3(3): 261-273. Find it on PubMed

Broderick, J. E., Junghaenel, D. U., et al. (2004). "Stability of patient adaptation classifications on the multidimensional pain inventory." Pain 109(1-2): 94-102. Find it on PubMed

Kerns, R. D., Turk, D. C., et al. (1985). "The West Haven-Yale Multidimensional Pain Inventory (WHYMPI)." Pain 23(4): 345-356. Find it on PubMed

Turk, D. C., Okifuji, A., et al. (1998). "Differential responses by psychosocial subgroups of fibromyalgia syndrome patients to an interdisciplinary treatment." Arthritis Care Res 11(5): 397-404. Find it on PubMed

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Year published

1985 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
west_haven_yale_multidimensional_pain_inventory.pdf    
Created at 3/15/2011 1:24 PM  by Jason Raad 
Last modified at 11/6/2013 4:58 PM  by Jason Raad