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Anxiety sensitivity and opioid misuse and dependence among trauma-exposed adults with chronic pain

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Abstract

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, Mage = 37.79 years, SD = 10.85, Mpain rating = 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.

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Notes

  1. In exploratory analyses we evaluated a moderated-mediation model for pain severity. There was no evidence of a moderational effect for pain.

  2. In exploratory analyses, we also ran a multiple mediation analysis for the PDS subscales in terms of opioid misuse and dependence. Results indicated that only the PDS arousal subscale mediated the relation between anxiety sensitivity and opioid misuse. There was no significant effect for opioid dependence.

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Zvolensky, M.J., Rogers, A.H., Shepherd, J.M. et al. Anxiety sensitivity and opioid misuse and dependence among trauma-exposed adults with chronic pain. J Behav Med 43, 174–184 (2020). https://doi.org/10.1007/s10865-020-00142-5

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