Difficulties in emotion regulation and chronic pain-related disability and opioid misuse

Lutz, Julie; Gross, Richard T.; Vargovich, Alison M.

doi:10.1016/j.addbeh.2018.07.018

Cited by 44 publications

(27 citation statements)

References 33 publications

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“…Upon repeated strengthening of this maladaptive coping strategy over more adaptive affect regulation solutions, emotional regulation difficulties may increase, thus enhancing the appeal of alcohol drinking that characterizes the vicious cycle of the disorder. This hypothesis has been supported by the results of Lutz and colleagues [26], where they found that greater emotional dysregulation was related to greater risk for opioid misuse in individuals with chronic pain. Thus, among individuals with AUD, higher pain sensitivity no longer characterizes better adaptation.…”

Section: Negative Affect Pain Sensitivity and Emotional Dysregulatimentioning

confidence: 67%

Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation

Kopera

Trucco

Suszek

et al. 2021

JCM

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Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study investigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD.

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Section: Negative Affect Pain Sensitivity and Emotional Dysregulatimentioning

confidence: 67%

Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation

Kopera

Trucco

Suszek

et al. 2021

JCM

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“…The same methods for evaluating the predictive value of indicators have been used previously. [30][31][32][33] Use of the PrEP adherence questionnaire provides the opportunity to evaluate patients' adherence in advance, such that a patient with low adherence can be detected prior to starting PrEP therapy. Individualbased measures can be used to improve adherence or to detect the need to use prevention measures other than PrEP, which could be more suitable for an individual and yield greater bene ts.…”

Section: Discussionmentioning

confidence: 99%

Reliability and Validity of a Free Oral Pre-exposure Prophylaxis (PrEP) Adherence Questionnaire Among Patients with Sexually Transmitted Infection and Without HIV Infection in Shanghai

Chen

et al. 2020

Preprint

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Objective: In this study, we aimed to evaluate the validity and reliability of the free oral pre-exposure prophylaxis (PrEP) adherence questionnaire among patients with sexually transmitted infection who do not have HIV infection in Shanghai. Methods: We conducted a cross-sectional study among 816 patients from sexually transmitted infection (STI) clinics in Shanghai. The questionnaire included self-reported demographic characteristics, items on adherence to free oral pre-exposure prophylaxis (PrEP), and PrEP uptake behavior measurement. Item analysis was carried out by calculating the critical ratio and item-total correlations. Internal consistency and split-half reliability were measured to assess reliability. Content validity, construct validity, convergent validity and discriminant validity were measured to assess validity. We conducted logistic regression with receiver operating characteristic (ROC) curve analysis to assess the predictive value of the adherence questionnaire for PrEP uptake behavior. Results: All items were considered acceptable in the item analysis (P<0.05). The questionnaire had a Cronbach’s alpha of 0.757 and split-half reliability of 0.633. The scale-level content validity index (CVI) was 0.938 and the item-level CVI of each item ranged from 0.750 to 1. In exploratory factor analysis, we introduced a four-factor model accounting for 79.838% of the aggregate variance with all factors loading more than 0.4, which was validated in confirmatory factor analysis (c2=47.1, degrees of freedom=14, root mean square error of approximation=0.078). According to regression analysis, adding PrEP adherence questionnaire scores contributed to prediction of PrEP uptake behavior (P<0.001). The maximum area under the ROC curve was 0.778 (95% confidence interval: 0.739–0.817), corresponding to a cutoff score of 9.Conclusion: The PrEP adherence questionnaire generally has acceptable reliability and validity. This questionnaire can be used as a tool to evaluate PrEP adherence in patients with STI who do not have HIV infection.

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“…This sample was part of a larger database from a previous study examining pain-related outcomes [ 26 ]. A sample of 212 patients with chronic pain presented to a multidisciplinary pain center at West Virginia University on referral from pain center physicians (52.8% female, mean age = 53.6, SD = 10.8).…”

Section: Methodsmentioning

confidence: 99%

Pain Experiences and Their Relation to Opioid Misuse Risk and Emotion Dysregulation

Nauser

Nelson

Gross

et al. 2020

Pain Research and Management

Self Cite

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Pain is a complex, multidimensional experience but often is measured as a unidimensional experience. This study aimed to separately assess the sensory and affective components of pain and identify their relations to important pain-related outcomes, particularly in terms of opioid misuse risk and emotion dysregulation among patients with chronic pain receiving treatment in Appalachia. Two hundred and twelve patients presenting to a multidisciplinary pain center completed the Difficulties in Emotion Regulation Scale (DERS-18), Screener and Opioid Assessment for Patients with Pain—Revised (SOAPP-R), and short-form McGill Pain Questionnaire (SF-MPQ). The sensory experience of pain was unrelated to emotion dysregulation (r = 0.06, p = 0.57 ) and weakly related to opioid misuse risk (r = 0.182, p < 0.05 ). In contrast, the affective experience of pain was moderately related to emotion dysregulation (r = 0.217, p < 0.05 ) and strongly related to opioid misuse risk (r = 0.37, p < 0.01 ). In addition, emotion dysregulation predicted variance in opioid misuse risk above and beyond the affective and sensory experiences of pain ((b = 0.693, p < 0.001 ). The results suggest patients with a strong affective experience versus sensory experience of pain and challenges with emotion regulation may require a more comprehensive intervention to address these underlying components in order to reduce their risk of misusing opioid medications.

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Difficulties in emotion regulation and chronic pain-related disability and opioid misuse

Cited by 44 publications

References 33 publications

Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation

Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation

Reliability and Validity of a Free Oral Pre-exposure Prophylaxis (PrEP) Adherence Questionnaire Among Patients with Sexually Transmitted Infection and Without HIV Infection in Shanghai

Pain Experiences and Their Relation to Opioid Misuse Risk and Emotion Dysregulation

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