Difficulties in emotion regulation and chronic pain-related disability and opioid misuse
Difficulties in emotion regulation and chronic pain-related disability and opioid misuse
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DOI：
10.1016/j.addbeh.2018.07.018
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发表时间：
2018-12-01
影响因子：
4.4
通讯作者：
Vargovich, Alison M.
中科院分区：
文献类型：
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作者：
Lutz, Julie;Gross, Richard T.;Vargovich, Alison M.
阿片类药物滥用的风险是慢性疼痛患者的一个重要考虑因素，因为最近美国阿片类药物相关死亡率很高，情绪调节困难可能与慢性疼痛结果（如阿片类药物滥用）有关，但也可能适合干预。本研究的目的是检查阿巴拉契亚慢性疼痛患者情绪调节困难与残疾和阿片类药物滥用风险之间的关联。情绪调节困难量表（DERS-18）、疼痛残疾指数（PDI）、疼痛患者筛选和阿片类药物评估-修订版（SOAPP-R）和当前阿片类药物滥用测量（COMM）收集自149例患者（年龄25-80岁，59%女性），这些患者前往行为医学科进行评估。DERS-18评分预测阿片类药物滥用和残疾风险的程度通过分层回归，逻辑回归和受试者工作特征（ROC）曲线分析进行检查。DERS-18评分解释了SOAPP-R中45%的方差，COMM评分中36%的方差和PDI评分中11%的方差。DERS-18评分增加1分与SOAPP-R测量的误用风险增加19%的几率相关，与COM测量的误用风险增加16%的几率相关。在ROC分析中，DERS-18是SOAPP-R（AUC = .85）和COMM（.83）风险的良好预测因子，30年代中期的截止评分显示出良好的灵敏度和特异性。情绪调节困难与功能较差有关，并且在这一人群中阿片类药物滥用的风险更大，但可能适合干预。
Risk for opioid misuse is a crucial consideration for patients with chronic pain, given the recent high rates of opioid-related deaths in the U.S. Emotion regulation difficulties may be associated with chronic pain outcomes such as opioid misuse, but may also be amenable to intervention. The aim of this study was to examine associations between difficulties with emotion regulation and disability and risk for opioid misuse among Appalachian chronic pain patients. The Difficulties in Emotion Regulation scale (DERS-18), Pain Disability Index (PDI), Screener and Opioid Assessment for Patients with Pain - Revised (SOAPP-R), and Current Opioid Misuse Measure (COMM) were collected from 149 patients (age 25-80, 59% female) presenting to a behavioral medicine department for evaluation. The extent to which DERS-18 scores predict risk for opioid misuse and disability was examined via hierarchical regression, logistic regression, and receiver operating characteristic (ROC) curve analyses. DERS-18 scores account for 45% of variance in SOAPP-R, 36% in COMM scores, and 11% in PDI scores. A one-point increase in DERS-18 score is associated with 19% greater odds of being at risk for misuse as measured by the SOAPP-R, and 16% greater odds on the COMM. In ROC analyses, the DERS-18 is a good predictor of risk on the SOAPP-R (AUC = .85) and COMM (.83), with cut-off scores in the mid-30s exhibiting good sensitivity and specificity. Difficulties in emotion regulation are associated with poorer functioning and with greater risk of opioid misuse in this population, but may be amenable to intervention.