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慢性疼痛成人中焦虑敏感与阿片类药物滥用之间关系的性别差异。

Sex differences in the relationship between anxiety sensitivity and opioid misuse among adults with chronic pain.

机构信息

Department of Psychology, University of Houston, Houston, TX, USA.

Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Health Institute, University of Houston, Houston, TX, USA.

出版信息

Addict Behav. 2020 Mar;102:106156. doi: 10.1016/j.addbeh.2019.106156. Epub 2019 Oct 17.

Abstract

The opioid epidemic is a significant public health concern linked to chronic pain. Despite efforts to change opioid prescribing practices for chronic pain, opioid-involved overdoses remain at an all-time high. Research focused on identifying individual difference factors for problematic opioid misuse in the context of chronic pain have identified certain psychological variables that may confer heightened risk for opioid-related problems. Anxiety sensitivity, or fear of anxiety-related physical sensations, has been linked to opioid-related problems among adults with chronic pain. Yet, it is possible that these relations may not be distributed equally in society, and sex differences may be one avenue by which these relations differ. Therefore, the current study examined the moderating role of sex on the relation between anxiety sensitivity, current opioid misuse, and severity of opioid dependence among 428 adults (74.9% female, M = 38.28 years, SD = 11.06) with chronic pain. Results indicated that the relation between anxiety sensitivity and current opioid misuse (ΔR = 0.005, B = 0.12, SE = 0.06, p = 0.04), and opioid dependence (ΔR = 0.01, B = 0.04, SE = 0.02, p = 0.007) was stronger for males compared to females. These results suggest that anxiety sensitivity may be associated with opioid-related problems to a greater extent for males than females. Continued research is needed to examine how these sex differences may impact clinical treatment for opioid-related problems.

摘要

阿片类药物流行是一个与慢性疼痛相关的重大公共卫生问题。尽管已经努力改变慢性疼痛患者的阿片类药物处方实践,但阿片类药物相关的过量用药仍然处于历史最高水平。研究集中于确定与慢性疼痛背景下的阿片类药物滥用相关的个体差异因素,已经确定了某些心理变量,这些变量可能会增加与阿片类药物相关问题的风险。焦虑敏感,即对焦虑相关身体感觉的恐惧,与慢性疼痛成年人的阿片类药物相关问题有关。然而,这些关系在社会中的分布可能并不均等,性别差异可能是这些关系不同的一个途径。因此,本研究考察了焦虑敏感、当前阿片类药物滥用和慢性疼痛成年人(74.9%为女性,平均年龄为 38.28 岁,标准差为 11.06)中性别对焦虑敏感与当前阿片类药物滥用和阿片类药物依赖严重程度之间关系的调节作用。结果表明,焦虑敏感与当前阿片类药物滥用(ΔR=0.005,B=0.12,SE=0.06,p=0.04)和阿片类药物依赖(ΔR=0.01,B=0.04,SE=0.02,p=0.007)之间的关系在男性中比女性更强。这些结果表明,焦虑敏感与男性的阿片类药物相关问题的关联程度可能大于女性。需要进一步研究如何这些性别差异可能会影响阿片类药物相关问题的临床治疗。

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