Skip to main content

Validation of the Orbach & Mikulincer Mental Pain Scale (OMMP) on a drug addicted population

Social Psychiatry and Psychiatric Epidemiology volume 49, pages 405–415 (2014)Cite this article

Abstract

Purpose

Recognizing the relevance of mental pain in drug addiction, this study aimed to adapt and validate the Portuguese translation of the Orbach & Mikulincer Mental Pain Scale (OMMP) on a drug addicted population and assess its psychometric properties.

Methods

The study sample (N = 403) was collected from several outpatient treatment centres for drug addiction and in therapeutic communities located in the north of Portugal. The validation of the OMMP Scale followed the same method considered by the authors of the original scale.

Results

A confirmatory factor analysis (CFA) was performed and did not confirm the structure of eight factors provided by the authors. An exploratory factor analysis revealed a five-factor model (labeled emptiness, irreversibility, emotional flooding, helplessness and confusion) leading to a reduction from 40 to 24 items. The OMMP-24-P showed acceptable levels for internal consistency and test–retest reliability. Confirmatory factor analysis indices supported the five-factor model. OMMP-24-P factors were positively correlated with measures of stress, anxiety and depression, negatively associated with quality of life, and showed small to moderate positive correlations with drug addiction severity, with exception of the helplessness factor.

Conclusions

This study has shown the OMMP-24-P to be a valid and reliable scale for assessment and evaluation of mental pain among drug addicts. Further research should attempt to determine the contribution that mental pain can provide towards an understanding of drug addiction dynamics and other psychopathological syndromes, and thereby contribute to the development of more effective treatment programs.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Weissman MM, Slobetz F, Prusoff B, Mezritz M, Howard P (1976) Clinical depression among narcotic addicts maintained on methadone in the community. Am J Psychiatry 133:1434–1441

    CAS  PubMed  Google Scholar 

  2. Fleming M (1995) Família e Toxicodependência. Afrontamento, Porto

  3. Neto D (1996) Tratamento Combinado e por Etapas de Heroinidependentes. Universitária Editora, Lisboa

  4. Fernandez C, Llorent J (1997) Ansiedad y Depressión en Heroinómanos. Colectanea de Textos das Taipas X pp 157–167

  5. Fergusson DM, Boden JM, Horwood LJ (2011) Structural models of the comorbidity of internalizing disorders and substance use disorders in a longitudinal birth cohort. Soc Psychiatry Psychiatr Epidemiol 46:933–942

    PubMed  Article  Google Scholar 

  6. Haw CM, Hawton K (2011) Problem drug use, drug misuse and deliberate self-harm: trends and patient characteristics, with a focus on young people, Oxford, 1993-2006. Soc Psychiatry Psychiatr Epidemiol 46:85–93

    PubMed  Article  Google Scholar 

  7. Jaques J (2001) Para acabar com as toxicomanias. Climepsi, Lisboa

  8. McDougall J (2001) L’économie psychique de l’addiction. In: Marinov V (ed) Anorexie, addictions et fragilités narcissiques, Collection Petite Bibliothèque de Psychanalyse. Presses Universitaires de France, Paris

  9. Agrawal A, Gardner CO, Prescott CA, Kendler KS (2005) The differential impact of risk factors on illicit drug involvement in females. Soc Psychiatry Psychiatr Epidemiol 40:454–466

    PubMed  Article  Google Scholar 

  10. Sequeira J (2006) As origens psicológicas da toxicomania. Climepsi, Lisboa

  11. Guimarães R, Fleming M (2009) Dor que Consome. Para uma compreensão da Dor Mental na Toxicodepêndencia. Toxicodependências 15:3–12

    Google Scholar 

  12. Olievenstein C, Angel P, Géraud B, Mége JY, Perpère A (eds) (1987) La Clinique du Toxicomane. Éditions Universitaires, Paris

  13. Fleming M (2005) Dor Mental e Toxicodependência. Toxicodependências 11:3–12

    Google Scholar 

  14. Freud S (ed) (1926) Inibição, sintoma e ansiedade. Imago, Rio de Janeiro

  15. Weiss E (1934) Bodily pain and mental pain. Int J Psychoanal 15:1–13

    Google Scholar 

  16. Akhtar S (2001) From mental pain through manic defense to mourning. In: Akhtar S (ed) Three faces of mourning: melancholia, manic defense, and moving on. Jason Aronson, New York

  17. Fleming M (2003) Dor sem Nome: Pensar o Sofrimento. Afrontamento, Porto

  18. Orbach I, Mikulincer M, Gilboa-Schechtman E, Sirota P (2003) Mental pain and its relationship to suicidality and life meaning. Suicide Life Threat Behav 33:231–241

    PubMed  Article  Google Scholar 

  19. Fleming M (2006) Distinction between mental pain and psychic suffering as separate entities in patient’s experience. Int Forum Psychoanal 15:1–3

    Article  Google Scholar 

  20. Shneidman ES (1976) Psychologic theory of suicide. Psychiat Ann 6:51–66

    Google Scholar 

  21. Shneidman ES (1981) Suicide thoughts and reflections, 1960–1980. Suicide Life Threat Behav 11:195–364

    CAS  PubMed  Google Scholar 

  22. Shneidman ES (1992) Rational suicide and psychiatric disorders. N Engl J Med 326:889–890 (author reply 890–881)

    CAS  PubMed  Article  Google Scholar 

  23. Shneidman ES (1993) Suicide as Psychache. J Nerv Ment Dis 181:145–147

    CAS  PubMed  Article  Google Scholar 

  24. Baumeister RF (1990) Suicide as escape from self. Psychol Rev 97:90–113

    CAS  PubMed  Article  Google Scholar 

  25. Bolger EA (1999) Grounded theory analysis of emotional pain. Psychother Res 9:342–362

    Google Scholar 

  26. Orbach I, Mikulincer M, Sirota P, Gilboa-Schechtman E (2003) Mental pain: a multidimensional operationalization and definition. Suicide Life Threat Behav 33:219–230

    PubMed  Article  Google Scholar 

  27. Bion WR (1963) Os Elementos da Psicanálise. Zahar, Rio de Janeiro

  28. Bion WR (1970) Atenção e Interpretação. Zahar, Rio de Janeiro

  29. Fleming M (2005) Towards a model of mental pain and psychic suffering. Can J Psychoanal 13:255–272

    Google Scholar 

  30. Bion WR (1962) The psycho-analytic study of thinking. A theor of thinking. Int J Psychoanal 43:306–310

    CAS  PubMed  Google Scholar 

  31. Shneidman ES (1999) The psychological pain acessement scale. Suicide Life-Threat 29:7

    Google Scholar 

  32. Holden RR, Metha K, Cunningham E, McLeod L (2001) Development and preliminary validation of a scale of psychache. Can J Behav Sci 33:8

    Article  Google Scholar 

  33. Dionne F, Labelle R, Daigle M, Baillargeon J (2004) Un nouveau venu en suicidologie: l’echelle du psymal. In: Communication présentée au Congrés Internationel des pratiques novatrices pour la prévention du suicide ed. Montreál

  34. Berlin MT, Mattevi BS, Pavanello DP, Caldieraro MA, Fleck MP, Wingate LR, Joiner TE (2003) Psychache and suicidality in adult mood disordered outpatients in Brazil. Suicide Life-Threat 33:7

    Google Scholar 

  35. Mills JF, Green K, Reddon J (2005) An evaluation of the psychache scale on an offender population. Suicide Life-Threat 35:10

    Article  Google Scholar 

  36. Muehlenkamp J (2005) Body regard and risk for self-injurious behavior in a sample of clinical and non-clinical adolescents. Department of Psychology. Northern Illinois university, DeKalb

    Google Scholar 

  37. Heo J (2008) Mental pain and suicide: exploring a causal path among trauma, object relations, mental pain and suicidal ideation. California School of Professional Psychology, Alliant International University, San Francisco, p 159

    Google Scholar 

  38. Levi Y, Horesh N, Fischel T, Treves I, Or E, Apter A (2008) Mental pain and its communication in medically serious suicide attempts: an “impossible situation”. J Affect Disord 111:244–250

    PubMed  Article  Google Scholar 

  39. Reisch T, Seifritz E, Esposito F, Wiest R, Valach L, Michel K (2010) An fMRI study on mental pain and suicidal behavior. J Affect Disord 126:321–325

    PubMed  Article  Google Scholar 

  40. van Heeringen K, Van den Abbeele D, Vervaet M, Soenen L, Audenaert K (2010) The functional neuroanatomy of mental pain in depression. Psychiatry Res 181:141–144

    PubMed  Article  Google Scholar 

  41. Beker G (2006) Suicide as an escape to the good self. Bar-Ilan University, Israel

    Google Scholar 

  42. Lovibond PF, Lovibond SH (1995) The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther 33:335–343

    CAS  PubMed  Article  Google Scholar 

  43. Lovibond PF (1998) Long-term stability of depression, anxiety, and stress syndromes. J Abnorm Psychol 107:520–526

    CAS  PubMed  Article  Google Scholar 

  44. Pais-Ribeiro JL, Honrado A, Leal I (2004) Contribuição para o estudo da adaptação portuguesa das Escalas de Ansiedade, Depressão e Stress(EADS) de 21 itens de Lovibond e Lovibond. Psicologia Saúde Doenças 5:229–240

    Google Scholar 

  45. Apóstolo J, Mendes A, Azeredo Z (2006) Adaptação para a língua portuguesa da Depression, Anxiety and Stress Scale (DASS). Rev Latino-Am Enfermagem 14

  46. Skinner HA (1982) The drug abuse screening test. Addict Behav 7:363–371

    CAS  PubMed  Article  Google Scholar 

  47. Staley D, el-Guebaly N (1990) Psychometric properties of the Drug Abuse Screening Test in a psychiatric patient population. Addict Behav 15:257–264

    CAS  PubMed  Article  Google Scholar 

  48. Cocco K, Carey K (1998) Psychometric properties of the Drug Abuse Screening Test in psychiatric outpatients. Psychol Assess 10:7

    Article  Google Scholar 

  49. Yudko E, Lozhkina O, Fouts A (2007) DAST psychometric properties. A comprehensive review of the psychometric properties of the Drug Abuse Screening Test. J Subst Abuse Treat 32:10

    Article  Google Scholar 

  50. Machado P, Klein J (2002) Teste de Triagem e Abuso de Drogas. Universidade do Minho, Braga

    Google Scholar 

  51. The WHOQOL Group (1996) What quality of life? The WHOQOL Group. World Health Organization Quality of Life Assessment. World Health Forum 17:354–356

    Google Scholar 

  52. The WHOQOL Group (1998) Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med 28:551–558

    Article  Google Scholar 

  53. Fleck MP, Chachamovich E, Trentini CM (2003) WHOQOL-OLD Project: method and focus group results in Brazil. Rev Saude Publica 37:793–799

    PubMed  Article  Google Scholar 

  54. Escudeiro R, Lamachã S, Freitas A, Silva H (2006) Qualidade de Vida e Toxicodependência. Toxicodependências 12:14

    Google Scholar 

  55. Vaz Serra A, Canavarro MC, Simões MR, Pereira M, Gameiro S, Quartilho MJ (2006) Estudos psicométricos do instrumento de avaliação da Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-Bref) para Português de Portugal. Psiquiatria Clínica 27:31–40

    Google Scholar 

  56. Ho R (2006) Handbook of univariate and multivariate data analysis and interpretation with SPSS. Chapman & Hall/CRC, Taylor & Francis Group, Boca Raton

  57. O’Connor BP (2000) SPSS and SAS programs for determining the number of components using parallel analysis and Velicer’s MAP test. Behav Res Meth Ins C 32:396–402

    Article  Google Scholar 

  58. Watkins MW (2006) Determining parallel analysis criteria. JMod Appl Stat Methods 5:344–346

    Google Scholar 

  59. Cronbach LJ (1951) Coefficient alpha and the internal structure of tests. Psychometrika 16:297–334

    Article  Google Scholar 

  60. Peterson RA (1994) A meta-analysis of Cronbach’s coefficient alpha. J Consumer Res 21:381–391

    Article  Google Scholar 

  61. Cronbach LJ (2004) My current thoughts on coefficient alpha and successor procedures. Educ Psychol Measur 64:391–418

    Article  Google Scholar 

  62. Nichols DP (1998) Choosing an interclass correlation coeficient. SPSS Keywords 67

  63. Fleiss JL (ed) (1986) The design and analysis of clinical experiments. John Wiley & Son, New York

    Google Scholar 

  64. Tabachnick BG, Fidell SF (2007) Using multivariate statistics, 5th edn. Pearson, United States of America

    Google Scholar 

  65. Orbach I (2003) Mental pain and suicide. Isr J Psychiatry Relat Sci 40:191–201

    PubMed  Google Scholar 

  66. Clerici M, Carta I, Cazzullo CL (1989) Substance abuse and psychopathology. A diagnostic screening of Italian narcotic addicts. Soc Psychiatry Psychiatr Epidemiol 24:219–226

    CAS  PubMed  Article  Google Scholar 

  67. Cacciola JS, Alterman AI, Rutherford MJ, McKay JR, Mulvaney FD (2001) The relationship of psychiatric comorbidity to treatment outcomes in methadone maintained patients. Drug Alcohol Depend 61:271–280

    CAS  PubMed  Article  Google Scholar 

  68. Baker KD, Lubman DI, Cosgrave EM, Killackey EJ, Yuen HP, Hides L, Baksheev GN, Buckby JA, Yung AR (2007) Impact of co-occurring substance use on 6 month outcomes for young people seeking mental health treatment. Aust N Z J Psychiatry 41:896–902

    PubMed  Article  Google Scholar 

  69. Lubman DI, Allen NB, Rogers N, Cementon E, Bonomo Y (2007) The impact of co-occurring mood and anxiety disorders among substance-abusing youth. J Affect Disord 103:105–112

    PubMed  Article  Google Scholar 

  70. Bayram N, Bilgel N (2008) The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students. Soc Psychiatry Psychiatr Epidemiol 43:667–672

    PubMed  Article  Google Scholar 

  71. Millson PE, Challacombe L, Villeneuve PJ, Fischer B, Strike CJ, Myers T, Shore R, Hopkins S, Raftis S, Pearson M (2004) Self-perceived health among Canadian opiate users: a comparison to the general population and to other chronic disease populations. Can J Public Health 95:99–103

    PubMed  Google Scholar 

  72. Rodríguez-Llera MC, Domingo-Salvany A, Brugal MT, Silva TC, Sánchez-Niubó A, Torrens M et al (2006) Psychiatric comorbidity in young heroin users. Drug Alcohol Depend 81:48–55

    Article  Google Scholar 

  73. Villeneuve PJ, Challacombe L, Strike CJ, Myers T, Fischer B, Shore R, Hopkins S, Millson PE (2006) Change in health-related quality of life of opiate users in low-threshold methadone programs. J Subst Use 11:137–149

    Article  Google Scholar 

  74. De Maeyer J, Vanderplasschen W, Broekaert E (2010) Quality of life among opiate-dependent individuals: a review of the literature. Int J Drug Policy 21:364–380

    PubMed  Article  Google Scholar 

Download references

Acknowledgments

The authors want to acknowledge Israel Orbach for his permission and contribution in the translation of the OMMP instrument, and the authors of the Portuguese versions of the Depression Anxiety Stress Scale (DASS-21), the Drug Abuse Screening Test (DAST) and World Health Organization’s Quality of Life instrument (WHOQOL-BREF) for their permission to use the instruments. The authors wish to thank the contribution of the Portuguese national centre for drug addiction (Instituto da Droga e da Toxicodependência), the therapeutic communities, the involved therapists for their contribution in the field work and all participants.

Conflict of interest

The authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. ICBAS, Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal

    Rui Guimarães, Manuela Fleming & Margarida Fonseca Cardoso

  2. Equipa Técnica/Direcção Regional Norte do Instituto da Droga e da Toxicodependência, CRI Ocidental do Porto, Rua Roberto Ivens, 472, 4450-248, Matosinhos, Portugal

    Rui Guimarães

  3. CIIMAR, Centro Interdisciplinar de Investigação Marinha e Ambiental, Rua dos Bragas 177, 4050-123, Porto, Portugal

    Margarida Fonseca Cardoso

Authors
  1. Rui Guimarães
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Manuela Fleming
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Margarida Fonseca Cardoso
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Margarida Fonseca Cardoso.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Guimarães, R., Fleming, M. & Cardoso, M.F. Validation of the Orbach & Mikulincer Mental Pain Scale (OMMP) on a drug addicted population. Soc Psychiatry Psychiatr Epidemiol 49, 405–415 (2014). https://doi.org/10.1007/s00127-013-0751-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-013-0751-6

Keywords

  • Mental pain
  • Addiction
  • Psychometrics
  • Reliability and validity
  • Factor analysis