Anxiety and Health Research Laboratory/Substance Use Treatment Clinic, Department of Psychology, University of Houston, 126 Fred J. Heyne Building, Suite 104, Houston, TX, 77204-5502, USA.
Department of Behavioral Sciences, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.
J Behav Med. 2020 Apr;43(2):174-184. doi: 10.1007/s10865-020-00142-5. Epub 2020 Feb 18.
It is unclear if anxiety sensitivity may serve as mechanism underlying the relation between posttraumatic stress symptom severity and opioid misuse and dependence among trauma-exposed persons with chronic pain. Therefore, the current study evaluated the explanatory role of anxiety sensitivity in the relations between posttraumatic stress symptom severity and opioid misuse and dependence. Participants included 294 trauma-exposed adults with chronic pain (71.4% female, M = 37.79 years, SD = 10.85, M = 7.32/10) that reported current moderate to severe chronic pain and prescription opioid use. Participants were recruited via an online national survey in the United States of America. There were statistically significant indirect effects of posttraumatic stress symptom severity via anxiety sensitivity in relation to opioid misuse and dependence. The indirect effects of the reverse models for opioid misuse and dependence also were significant and suggest the potential for bi-directional relations; however, the magnitude of the effect was smaller in the tests of specificity than in the original models. The present findings provide initial empirical evidence that greater posttraumatic stress symptom severity is related to anxiety sensitivity, which in turn, is associated with increased opioid misuse and dependence among trauma-exposed individuals with chronic pain.
焦虑敏感是否可能是创伤后应激症状严重程度与慢性疼痛创伤暴露个体阿片类药物滥用和依赖之间关系的潜在机制尚不清楚。因此，本研究评估了焦虑敏感在创伤后应激症状严重程度与阿片类药物滥用和依赖之间关系中的解释作用。参与者包括 294 名有慢性疼痛的创伤暴露成年人（71.4%为女性，M=37.79 岁，SD=10.85，M=7.32/10），报告当前有中度至重度慢性疼痛和处方阿片类药物使用。参与者是通过美国的一项在线全国性调查招募的。创伤后应激症状严重程度通过焦虑敏感性与阿片类药物滥用和依赖呈显著间接关系。阿片类药物滥用和依赖的反向模型的间接效应也具有统计学意义，表明存在双向关系的可能性；然而，特异性检验中的效应量小于原始模型。本研究结果提供了初步的实证证据，表明创伤后应激症状严重程度与焦虑敏感有关，而焦虑敏感又与慢性疼痛的创伤暴露个体中阿片类药物滥用和依赖的增加有关。
