MMPI-2-RF Profiles of Treatment-Seeking Veterans in a VA Pain Clinic and Associations with Markers of Physical Performance.

Chronic pain is a debilitating condition for many military Veterans and is associated with posttraumatic stress disorder (PTSD). This study examined the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in 144 Veterans (88.2% male, mean age = 57.95 years) recruited from a VA outpatient pain clinic and associations with self-reported pain severity, pain-related interference in daily activities, prescription opioid use, and objective metrics of physical performance on tasks impacted by pain (walking, stair climbing, grip strength, indexed by a single latent variable). Among the cohort with valid responses on the MMPI-2-RF (n = 117) and probable PTSD, mean Somatic Complaints (RC1) and Ideas of Persecution (RC6) scores were clinically elevated. All MMPI-2-RF scales were more strongly correlated with self-reported pain interference than severity. Regressions revealed associations between self-rated pain interference (but not pain or PTSD severity) and physical performance scores (ß = .36, p = .001). MMPI-2-RF overreporting Validity and Higher-Order scales contributed incremental variance in predicting physical performance, including Infrequent Psychopathology Responses (ß = .33, p = .002). PTSD severity was associated with prescription opioid use when accounting for the effects of over-reported somatic and cognitive symptoms (odds ratio 1.05, p ≤ .025). Results highlight the role of symptom overreporting and perceptions of functional impairment to observable behaviors among individuals with chronic pain.

Force application during cochlear implant insertion: an analysis for improvement of surgeon technique.

Highly invasive surgical procedures, such as the implantation of a prosthetic device, require correct force delivery to achieve desirable outcomes and minimize trauma induced during the operation. Improvement in surgeon technique can reduce the chances of excessive force application and lead to optimal placement of the electrode array. The fundamental factors that affect the degree of success for cochlear implant recipients are identified through empirical methods. Insertion studies are performed to assess force administration and electrode trajectories during implantations of the Nucleus 24 Contour and Nucleus 24 Contour Advance electrodes into a synthetic model of the human Scala Tympani, using associated methods. Results confirm that the Advance Off- Stylet insertion of the soft-tipped Contour Advance electrode gives an overall reduction in insertion force. Analysis of force delivery and electrode positioning during cochlear implantation can help identify and control key factors for improvement of insertion method. Based on the findings, suggestions are made to enhance surgeon technique.