Bichon Juliette A, Bailey Allen J, Ford Stephanie Friree, Lesser Victoria S, McHugh R Kathryn
From McLean Hospital (Drs. Bailey and McHugh, and Mss. Bichon and Friree Ford), Belmont, MA; Harvard Medical School (Drs. Bailey and McHugh); Brandeis University (Ms. Lesser).
Harv Rev Psychiatry. 2025;33(1):8-30. doi: 10.1097/HRP.0000000000000415.
Pain catastrophizing, or the interpretation of pain as unbearable or intolerable, can increase pain-related anxiety and severity. High levels of pain catastrophizing have also been linked to substance use, particularly for substances with analgesic properties. Importantly, behavioral treatments can reduce pain catastrophizing, making them promising interventions for mitigating pain-related substance use. The aim of this scoping review is to summarize literature investigating the relationship between pain catastrophizing and substance use in adults.
We performed a scoping review of peer-reviewed literature. Included articles had both a measurement of pain catastrophizing and substance use, and reported analyses characterizing the relationship between the two.
Of the 341 abstracts identified, 47 articles met eligibility criteria. Most studies focused on people with chronic pain. Some studies also considered samples with substance use disorders (with and without chronic pain) or acute pain, and general population samples. There was generally a positive association between pain catastrophizing and substance misuse; this association was consistent across multiple samples and substances. Most studies were cross-sectional, although associations were also detected in longitudinal studies. The magnitude of associations tended to be stronger for higher severity substance use and more proximal tests of association. More longitudinal and experimental studies are needed, however, to better delineate these effects.
Findings indicate a consistent positive association between pain catastrophizing and substance use, highlighting the potential for interventions targeting pain catastrophizing to reduce negative substance-related consequences.
疼痛灾难化，即将疼痛解读为无法忍受或难以承受，会增加与疼痛相关的焦虑和严重程度。高水平的疼痛灾难化还与物质使用有关，尤其是具有镇痛特性的物质。重要的是，行为治疗可以减少疼痛灾难化，使其成为减轻与疼痛相关物质使用的有前景的干预措施。本范围综述的目的是总结研究成年人疼痛灾难化与物质使用之间关系的文献。
我们对同行评审文献进行了范围综述。纳入的文章既测量了疼痛灾难化又测量了物质使用，并报告了描述两者之间关系的分析。
在识别出的341篇摘要中，47篇文章符合纳入标准。大多数研究聚焦于慢性疼痛患者。一些研究还考虑了有物质使用障碍（有或无慢性疼痛）或急性疼痛的样本以及普通人群样本。疼痛灾难化与物质滥用之间通常存在正相关；这种关联在多个样本和物质中是一致的。大多数研究是横断面研究，不过在纵向研究中也检测到了关联。对于更高严重程度的物质使用和更直接的关联测试，关联程度往往更强。然而，需要更多的纵向和实验研究来更好地描述这些影响。
研究结果表明疼痛灾难化与物质使用之间存在一致的正相关，突出了针对疼痛灾难化的干预措施减少与物质相关负面后果的潜力。
