The Role of Anxiety Sensitivity in the Relation Between Pain Intensity with Substance Use and Anxiety and Depressive Sym
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The Role of Anxiety Sensitivity in the Relation Between Pain Intensity with Substance Use and Anxiety and Depressive Symptoms Among Smokers with Chronic Pain Michael J. Zvolensky 1,2,3 & Andrew H. Rogers 1 & Lorra Garey 1 & Joseph W. Ditre 4 & Justin M. Shepherd 1 & Andres G. Viana 1,5 & Brooke Y. Kauffman 1 & Michael Businelle 6
# International Society of Behavioral Medicine 2020
Abstract Background The additive effect of experiencing chronic pain in the context of nicotine addiction places smokers with chronic pain at elevated risk for experiencing physical and mental health problems. Isolating factors that explain linkages between pain and health-related outcomes among smokers with chronic pain is an important next step. Therefore, the current study examined the explanatory role of anxiety sensitivity in relations between pain intensity and current opioid misuse, severity of opioid dependence, tobacco-related problems, and anxiety/depressive symptoms. Method Participants were 187 (Mage = 39.02, SD = 9.94, 74.9% female) daily smokers with chronic pain who completed a battery of self-report measures on pain experience, anxiety sensitivity, tobacco and opioid use, and anxiety/depression symptoms. Indirect effect analyses were conducted to examine anxiety sensitivity as a mediator of the relations between pain intensity and health-related outcomes. Results A significant indirect effect emerged for pain intensity, through anxiety sensitivity, on opioid misuse (ab = 0.83, SE = 0.24, 95% CI [0.39, 1.34], CSE = 0.17), severity of opioid dependence (ab = 0.17, SE = 0.05, 95% CI [0.08, 0.26], CSE = 0.16), tobacco use problems (ab = 0.16, SE = 0.06, 95% CI [0.07, 0.28], CSE = 0.11), and anxiety/depressive symptoms (ab = 0.20, SE = 0.06, 95% CI [0.10, 0.31], CSE = 0.19). Conclusion The current investigation highlights the potential importance of anxiety sensitivity in terms of the experience of pain with severity of substance use and anxiety/depressive symptoms among smokers with chronic pain. Keywords Smoking . Pain . Anxiety sensitivity . Opioid . Tobacco
Introduction
* Michael J. Zvolensky [email protected] 1
Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
2
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, USA
3
HEALTH Institute, University of Houston, Houston, USA
4
Department of Psychology, Syracuse University, Syracuse, USA
5
Texas Institute of Measurement, Evaluation, and Statistics, Houston, USA
6
Oklahoma Health Sciences, Oklahoma City, USA
Substantial empirical evidence suggests smoking and chronic pain co-occur at high rates (i.e., 28.3%; [1]). Moreover, estimates suggest that the prevalence of smoking among persons with chronic pain is steadily increasing whereas prevalence of smoking in the general population is declining [1]. Some work suggests that smokers with greater dependence on tobacco are more likely to experience chronic pain [2]. Importantly, the comorbidity b
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