Mindfulness is Associated With Increased Hedonic Capacity Among Chronic Pain Patients Receiving Extended Opioid Pharmacotherapy.
Mindfulness is Associated With Increased Hedonic Capacity Among Chronic Pain Patients Receiving Extended Opioid Pharmacotherapy.
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DOI：
10.1097/ajp.0000000000000379
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发表时间：
2017-02
期刊：
影响因子：
--
通讯作者：
Garland EL
中科院分区：
文献类型：
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作者：
Thomas EA;Garland EL
慢性疼痛和长期使用阿片类药物可能导致享乐能力的持续缺陷，其特征是对厌恶状态的敏感性增加和对自然奖励的不敏感性。气质正念与改善情绪调节和疼痛应对有关。当前研究的目的是在使用阿片类药物的慢性疼痛样本中检查气质正念、享乐能力和疼痛相关干扰之间的关联。数据来自115名接受长期阿片类药物治疗的慢性疼痛患者（68%为女性，M年龄=48.3，SD=13.6），这些患者完成了五方面正念问卷（FFMQ）、Snaith汉密尔顿快感缺失和快乐量表（SHAPS）、简明疼痛量表（BPI）和重度抑郁症的精神病学评估。双变量相关，分层多元回归和路径分析被用来确定是否气质正念分数（FFMQ）预测的享乐能力（SHAPS）的方差，以及如果享乐能力介导的正念和疼痛干扰之间的关联。我们观察到气质正念和享乐能力得分之间存在显著的正相关，r= 0.33，p<0.001。分层回归表明，在控制了疼痛干扰和重性抑郁症诊断后，气质正念解释了享乐能力的显著差异（Beta = 0.30，p<0.01）。性格正念和疼痛干扰之间的关联是由享乐能力介导的（B =-0.011，SE= 0.005，95% CI）。= −.004至−.024，全模型R2=.39）。研究结果表明，性格正念与享乐能力之间的慢性疼痛样本。鉴于这种关联，增加正念的干预措施可能会通过增强享乐能力来减少阿片类药物使用患者的疼痛相关损害。
Chronic pain and long-term opioid use may lead to a persistent deficit in hedonic capacity, characterized by increased sensitivity to aversive states and insensitivity to natural rewards. Dispositional mindfulness has been linked with improved emotion regulation and pain coping. The aim of the current study was to examine associations between dispositional mindfulness, hedonic capacity, and pain-related interference in an opioid-using chronic pain sample. Data were obtained from a sample of 115 chronic pain patients on long-term opioid therapy (68% females, M age=48.3, SD=13.6) who completed the Five Facet Mindfulness Questionnaire (FFMQ), the Snaith Hamilton Anhedonia and Pleasure Scale (SHAPS), the Brief Pain Inventory (BPI), and a psychiatric assessment of major depression. Bivariate correlations, hierarchical multiple regression, and path analysis were used to determine if dispositional mindfulness scores (FFMQ) predicted variance in hedonic capacity (SHAPS), and if hedonic capacity mediated the association between mindfulness and pain interference. We observed a significant positive correlation between dispositional mindfulness and hedonic capacity scores, r=.33, p<.001. Hierarchical regression indicated that after controlling for pain interference and major depressive disorder diagnosis, dispositional mindfulness explained a significant portion of variance in hedonic capacity (Beta = .30, p< .01). The association between dispositional mindfulness and pain interference was mediated by hedonic capacity (b = −.011, SE=.005, 95% C.I. = −.004 to −.024, full model R2=.39). Findings indicate that dispositional mindfulness was associated with hedonic capacity among this chronic pain sample. In light of this association, it is plausible that interventions that increase mindfulness may reduce pain-related impairment among opioid-using patients by enhancing hedonic capacity.