Abstract
Objectives: The concept of Chemical Coping proposes that patients suffering from chronic pain might utilize their pain medication to ameliorate coexisting distressful emotional states. Primary objective of this study was the preliminary evaluation of the German version of the Chemical Coping Index (CCI-D) in 80 patients with somatoform diseases as well as the development and evaluation of a short-scale.
Methods: The psychometric properties of the CCI-D were tested via item analysis and reliability analysis (Cronbach's coefficient alpha). To evaluate the short-scale of the CCI-D item analysis, reliability analysis, confirmatory factor analysis and concurrent correlation analysis were performed.
Results: The scale structure of the original version of the CCI could not be replicated distinctly. The CCI-D12 was highly reliable (α = 0.92), explained 51% of variance and showed plausible values in confirmatory modell-fit-indices. Chemical Coping was significantly correlated with an increased intake of pain medication (P ≪ 0.01), defiance of medical intake instructions (P ≪ 0.01), and highly associated with experienced withdrawal symptoms (P ≪ 0.001), fear (P ≪ 0.05), hypochondria (P ≪ 0.01), psychosocial distress (P ≪ 0.001), and alexithymia (P ≪ 0.001). Patients did not differ significantly in somatization and pain disability.
Conclusion: The German short-scale CCI-D12 is a reliable and valid instrument assessing patterns of chemical coping and misuse of pain medication.
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