Assayag Naama, Bonneh Yoram, Parush Shula, Mell Haim, Kaplan Neeman Ricky, Bar-Shalita Tami
Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel.
School of Optometry and Vision Science, Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.
Pain Med. 2020 Sep 1;21(9):1902-1912. doi: 10.1093/pm/pnz292.
This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD.
Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)-Revised.
The SUD group scored higher on the PSQ (P < 0.0001), BAS-R aversiveness (P < 0.0001), BAS-R-unpleasantness (P < 0.0001), and on the aftersensation of auditory aversiveness (P < 0.0001) and unpleasantness (P < 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P < 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ.
This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.
本比较性横断面研究旨在描述物质使用障碍(SUD)个体在疼痛敏感性自我认知、实验性听觉厌恶感和非伤害性感觉反应性方面的特征,并研究其与SUD的关联。
患有SUD的治疗社区(TC)个体(N = 63,男性占88.9%)和健康对照组(N = 60,男性占86.7%)完成了疼痛敏感性问卷(PSQ)和感觉反应性问卷-强度量表(SRQ-IS),随后进行了心理物理学听觉测试,即修订后的声音厌恶感测试组(BAS)。
SUD组在PSQ(P < 0.0001)、BAS-R厌恶感(P < 0.0001)、BAS-R不愉快感(P < 0.0001)以及听觉厌恶感的后感觉(P < 0.0001)和不愉快感(P < 0.000)上得分更高。SUD组中有54%被确定为具有感觉调制功能障碍(SMD),而对照组中这一比例为11.7%(P < 0.0001)。逻辑回归模型显示,SRQ-IS-厌恶得分具有更强的相关性,表明SUD的优势比为12.6倍(P = 0.0002)。最后,基于PSQ和SRQ,给出了根据逻辑回归模型参数的线性组合计算出的风险评分。
这是第一项使用实验和现场自我报告来探索感觉和厌恶领域的研究,揭示了与SMD高患病率同时出现的疼痛感知改变,特别是过度反应类型。这些发现可能在临床实践中对治疗疼痛具有重要意义,并且对于在TC及其他环境中作为更广泛康复的一部分扩展治疗方式以更好地满足个性化治疗也具有重要意义。