Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA.
Drug Alcohol Depend. 2021 Jan 1;218:108387. doi: 10.1016/j.drugalcdep.2020.108387. Epub 2020 Oct 24.
Alexithymia, difficulty identifying and describing one's emotions coupled with a tendency to externalize, is a potentially important yet understudied treatment target for patients with opioid use disorder. The aim of this study was to examine the role of alexithymia in pain experience among individuals with opioid use disorder.
One-hundred-and-sixty-four patients receiving methadone maintenance treatment completed a battery of self-report measures related to alexithymia, drug use, and pain experiences. Comparisons were performed on the full sample between those with or without clinically significant levels of alexithymia. For a subsample reporting pain (n = 138), intercorrelations were performed to test whether drug use history, pain catastrophizing, pain acceptance, and alexithymia were related to pain severity and pain interference. Regression analyses were performed to test for serial mediation of pain catastrophizing and pain acceptance on the relationship between alexithymia and pain interference in this subsample.
Individuals with alexithymia showed increased pain catastrophizing and interference, and intercorrelations indicated that increased alexithymia was associated with increased pain interference, more pain catastrophizing, and reduced pain acceptance. A serial regression model among a subset of patients with pain indicated that pain catastrophizing and pain acceptance mediated the effect of alexithymia on pain interference.
These findings suggest that alexithymia, as well as both pain catastrophizing and pain acceptance, contribute to interference associated with pain and are potentially important intervention targets among methadone-treated patients with pain.
述情障碍是一种潜在的重要但研究不足的治疗靶点，其特点是难以识别和描述自己的情绪，并且倾向于外化。对于阿片类药物使用障碍患者，述情障碍是疼痛体验的一个重要因素。
164 名接受美沙酮维持治疗的患者完成了一系列与述情障碍、药物使用和疼痛体验相关的自我报告量表。在全样本中，对有或没有临床显著述情障碍的患者进行了比较。对于报告疼痛的亚样本（n=138），进行了相关性分析，以检验药物使用史、疼痛灾难化、疼痛接受度和述情障碍与疼痛严重程度和疼痛干扰的关系。回归分析检验了疼痛灾难化和疼痛接受度在述情障碍与疼痛干扰关系中的序列中介作用。
有述情障碍的个体表现出更高的疼痛灾难化和干扰，相关性分析表明，述情障碍增加与疼痛干扰增加、疼痛灾难化增加和疼痛接受度降低有关。在有疼痛的亚组患者中，一个序列回归模型表明，疼痛灾难化和疼痛接受度中介了述情障碍对疼痛干扰的影响。
这些发现表明，述情障碍以及疼痛灾难化和疼痛接受度，都与疼痛相关的干扰有关，是接受美沙酮治疗的疼痛患者潜在的重要干预靶点。
