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阿片类药物依赖中对不确定性的不耐受——与特质焦虑和冲动性的关系。

Intolerance of uncertainty in opioid dependency - Relationship with trait anxiety and impulsivity.

作者信息

Garami Julia, Haber Paul, Myers Catherine E, Allen Michael T, Misiak Blazej, Frydecka Dorota, Moustafa Ahmed A

机构信息

School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia.

National Health and Medical Research Council Centre of Research Excellence in Mental Health and Substance Use, Discipline of Addiction Medicine, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

PLoS One. 2017 Jul 31;12(7):e0181955. doi: 10.1371/journal.pone.0181955. eCollection 2017.

Abstract

Intolerance of uncertainty (IU) is the tendency to interpret ambiguous situations as threatening and having negative consequences, resulting in feelings of distress and anxiety. IU has been linked to a number of anxiety disorders, and anxiety felt in the face of uncertainty may result in maladaptive behaviors such as impulsive decision making. Although there is strong evidence that anxiety and impulsivity are risk factors for addiction, there is a paucity of research examining the role of IU in this disorder. The rate of opioid addiction, in particular, has been rising steadily in recent years, which necessitates deeper understanding of risk factors in order to develop effective prevention and treatment methods. The current study tested for the first time whether opioid-dependent adults are less tolerant of uncertainty compared to a healthy comparison group. Opioid dependent patients undergoing methadone maintenance therapy (n = 114) and healthy comparisons (n = 69) completed the following scales: Intolerance of Uncertainty Scale, the Barrett Impulsivity Scale, and the State Trait Anxiety Inventory. Analysis revealed that these measures were positively correlated with each other and that opioid-dependent patients had significantly higher IU scores. Regression analysis revealed that anxiety mediated the relationship between IU and impulsivity. Hierarchical moderation regression found an interaction between addiction status and impulsivity on IU scores in that the relationship between these variables was only observed in the patient group. Findings suggest that IU is a feature of addiction but does not necessarily play a unique role. Further research is needed to explore the complex relationship between traits and how they may contribute to the development and maintenance of addiction.

摘要

对不确定性的不耐受(IU)是指将模糊情境解释为具有威胁性并会产生负面后果的倾向,从而导致痛苦和焦虑情绪。IU与多种焦虑症有关,面对不确定性时产生的焦虑可能会导致冲动决策等适应不良行为。尽管有充分证据表明焦虑和冲动是成瘾的风险因素,但关于IU在这种疾病中的作用的研究却很少。特别是近年来,阿片类药物成瘾率一直在稳步上升,因此有必要更深入地了解风险因素,以便制定有效的预防和治疗方法。本研究首次测试了与健康对照组相比,阿片类药物依赖的成年人是否对不确定性的耐受性更低。接受美沙酮维持治疗的阿片类药物依赖患者(n = 114)和健康对照组(n = 69)完成了以下量表:不确定性不耐受量表、巴雷特冲动量表和状态特质焦虑量表。分析表明,这些测量结果之间呈正相关,且阿片类药物依赖患者的IU得分显著更高。回归分析表明,焦虑介导了IU与冲动性之间的关系。分层调节回归发现成瘾状态和冲动性对IU得分存在交互作用,即这些变量之间的关系仅在患者组中观察到。研究结果表明,IU是成瘾的一个特征,但不一定发挥独特作用。需要进一步研究来探索特质之间的复杂关系以及它们如何可能导致成瘾的发展和维持。

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