Rogers Andrew H, Garey Lorra, Bakhshaie Jafar, Viana Andres G, Ditre Joseph W, Zvolensky Michael J
Department of Psychology.
Department of Psychiatry, Baylor College of Medicine.
Clin J Pain. 2020 Nov;36(11):862-867. doi: 10.1097/AJP.0000000000000870.
The opioid epidemic is a significant public health problem largely driven by opioid prescriptions for chronic pain. Among those with chronic pain, anxiety and depressive symptoms have been linked to opioid misuse, and individual differences in anxiety and depressive symptoms among adults with chronic pain may be important for better understanding pain. Yet, little work has examined mechanisms that may link anxiety and depressive symptoms to opioid misuse among adults with chronic pain. Anxiety sensitivity (AS), or the fear of anxiety-related physical sensations, may be one candidate construct that has been linked independently to anxiety and depressive symptoms as well as opioid misuse.
The current survey-based study examined the indirect association of AS in the relation between anxiety and depressive symptoms and opioid misuse among 429 adults with chronic pain currently using prescription opioid medication (73.9% female, Mage=38.32 y, SD=11.07).
Using structural equation modeling, it appears that AS is a potential construct in the interrelation between anxiety and depressive symptoms and opioid misuse. However, an alternative model found equally strong empirical support, as mental health symptoms may serve as an explanatory factor between AS and opioid misuse.
Bi-directional effects are apt to be involved among the studied variables. Prospective research is needed to replicate the study results and isolate the temporal patterning between the studied constructs. Nonetheless, the data overall highlight the importance of both AS and anxiety and depressive symptoms in terms of understanding opioid misuse among adults with chronic pain.
阿片类药物泛滥是一个重大的公共卫生问题，主要由慢性疼痛的阿片类药物处方所驱动。在慢性疼痛患者中，焦虑和抑郁症状与阿片类药物滥用有关，慢性疼痛成年人中焦虑和抑郁症状的个体差异可能对更好地理解疼痛很重要。然而，很少有研究探讨可能将焦虑和抑郁症状与慢性疼痛成年人阿片类药物滥用联系起来的机制。焦虑敏感性（AS），即对与焦虑相关的身体感觉的恐惧，可能是一个独立与焦虑、抑郁症状以及阿片类药物滥用相关的候选构念。
当前基于调查的研究考察了429名目前正在使用处方阿片类药物的慢性疼痛成年人（73.9%为女性，年龄中位数=38.32岁，标准差=11.07）中，焦虑敏感性在焦虑和抑郁症状与阿片类药物滥用关系中的间接关联。
使用结构方程模型，焦虑敏感性似乎是焦虑和抑郁症状与阿片类药物滥用相互关系中的一个潜在构念。然而，另一个模型也得到了同样有力的实证支持，因为心理健康症状可能是焦虑敏感性和阿片类药物滥用之间的一个解释因素。
在所研究的变量之间可能存在双向效应。需要进行前瞻性研究来重复研究结果，并分离所研究构念之间的时间模式。尽管如此，总体数据凸显了焦虑敏感性以及焦虑和抑郁症状在理解慢性疼痛成年人阿片类药物滥用方面的重要性。
