RT Journal Article T1 The Mediating Role of Psychological Flexibility and Inflexibility Between Impulsivity and Opioid Misuse in People With Chronic Noncancer Pain A1 Barrado-Moreno, Victoria A1 Esteve-Zarazaga, Rosa A1 McCracken, Lance M. A1 Ramírez-Maestre, María del Carmen K1 Opiáceos - Abuso K1 Dolor - Aspectos psicológicos K1 Adaptación (Psicología) AB BackgroundThe prescription of opioid medication is a frequent therapeutic approach in chronic noncancer pain, as is misuse of prescribed opioids. 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-related outcomes and opioid misuse. The aim of this cross-sectional 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.MethodsThe sample comprised 155 people with chronic noncancer pain. A hypothetical model was tested using correlation and structural equation modelling analyses.ResultsThe 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.ConclusionsIt 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. PB Wiley SN 1090-3801 YR 2025 FD 2025-05-26 LK https://hdl.handle.net/10630/39082 UL https://hdl.handle.net/10630/39082 LA eng NO Barrado‐Moreno, V., Esteve, R., McCracken, L. M., & Ramírez‐Maestre, C. (2025). The Mediating Role of Psychological Flexibility and Inflexibility Between Impulsivity and Opioid Misuse in People With Chronic Noncancer Pain. European Journal of Pain, 29(6). NO Funding for open access charge: Universidad de Málaga / CBUA DS RIUMA. Repositorio Institucional de la Universidad de Málaga RD 4 mar 2026