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There is previous evidence for associations between personal variables such as impulsivity and opioid misuse. Psychological flexibility and inflexibility have also been associated with pain\u2010related outcomes and opioid misuse. The aim of this cross\u2010sectional study was to examine the combined role of a dispositional variable (impulsivity) along with psychological factors (Psychological Flexibility and Inflexibility) in pain outcomes and opioid misuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The sample comprised 155 people with chronic noncancer pain. A hypothetical model was tested using correlation and structural equation modelling analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results show significant associations between impulsivity and Psychological Flexibility, Psychological Inflexibility and opioid misuse. Psychological Flexibility and Inflexibility were related to pain intensity, interference and opioid misuse. Structural equation modelling showed significant associations between impulsivity, Psychological Inflexibility and pain interference, and opioid misuse. Associations between Psychological Flexibility and pain interference and opioid misuse were nonsignificant. These results support the hypothesis that impulsivity and Psychological Inflexibility are factors that contribute to pain interference and opioid misuse, but do not support the hypothesis that Psychological Flexibility reduces opioid misuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It is recommended to assess these psychological aspects prior to the prescription of opioid medication, and, if necessary, offering Acceptance and Commitment and Mindfulness Based Therapies could be desirable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>The results of this study provide further evidence of the role of trait impulsivity as a transdiagnostic antecedent variable in opioid misuse, both by a direct association and through psychological inflexibility. It can be drawn from these results that psychological transdiagnostic variables, rather than pain outcomes alone, would be key factors influencing opioid misuse. These findings underscore the need for comprehensive psychological assessments prior to the prescription of opioids.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70048","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T07:55:03Z","timestamp":1748246103000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Mediating Role of Psychological Flexibility and Inflexibility Between Impulsivity and Opioid Misuse in People With Chronic Noncancer Pain"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6554-4429","authenticated-orcid":false,"given":"Victoria","family":"Barrado\u2010Moreno","sequence":"first","affiliation":[{"name":"Facultad de Psicolog\u00eda y Logopedia Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4474-7432","authenticated-orcid":false,"given":"Rosa","family":"Esteve","sequence":"additional","affiliation":[{"name":"Facultad de Psicolog\u00eda y Logopedia Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9734-0153","authenticated-orcid":false,"given":"Lance M.","family":"McCracken","sequence":"additional","affiliation":[{"name":"Department of Psychology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3245-7844","authenticated-orcid":false,"given":"Carmen","family":"Ram\u00edrez\u2010Maestre","sequence":"additional","affiliation":[{"name":"Facultad de Psicolog\u00eda y Logopedia Universidad de M\u00e1laga  M\u00e1laga Spain"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de M\u00e1laga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND)  M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.04.005"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2021.09.001"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025\u20107753(03)73601\u2010X"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12144\u2010025\u201007421\u2010x"},{"key":"e_1_2_7_6_1","volume-title":"Modelos de ecuaciones estructurales","author":"Batista Foguet J. 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