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

Jonathan W Nauser,Richard T Gross,Cecelia I Nelson,Alison M Vargovich

doi:10.1155/2020/7234625

Abstract

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.

Highlights

Chronic pain is understood to be a complex biopsychosocial experience [1]; measurement of pain in many clinical settings fails to differentiate between these symptom domains
Patients report that a numeric rating scale alone does not capture their subjective experience of pain despite its common use in medical settings [7]
Patients with a higher affective experience of pain may be at increased risk for emotion dysregulation or opioid misuse relative to those who have a stronger sensory experience of pain

Summary

Introduction

Chronic pain is understood to be a complex biopsychosocial experience [1]; measurement of pain in many clinical settings fails to differentiate between these symptom domains. Is research suggests that opioids are prescribed with the goal of alleviating nociceptive pain, or the sensory experience of pain, individuals may continue using opioid medication or misusing it due to its affective or emotional effects (i.e., an unhealthy emotion regulation strategy for chronic pain). To date, limited research has investigated the affective and sensory experiences of chronic pain and their relation with opioid misuse and emotion dysregulation.

Results

Conclusion