Volume 142, July 2023, 107668Author links open overlay panel, , , , Abstract

Trauma-exposure and posttraumatic stress symptoms increase risk for opioid-related problems in the context of chronic pain. Yet, there has been little exploration of moderators of the posttraumatic stress-opioid misuse association. Pain-related anxiety, defined as worry about pain and the negative consequences of pain, has shown relations to both posttraumatic stress symptoms and opioid misuse, and it may moderate the association between posttraumatic stress symptoms and opioid misuse, as well as dependence. The current study examined the moderating role of pain-related anxiety on the relationship between posttraumatic stress symptoms and opioid misuse and dependence among 292 (71.6 % female, Mage = 38.03 years, SD = 10.93) trauma exposed adults with chronic pain. Results indicated that pain-related anxiety significantly moderated the observed relations, such that compared to those with low pain-related anxiety, the relationship between posttraumatic stress symptoms and opioid misuse and dependence was stronger for those with elevated pain-related anxiety. These results highlight the importance of assessing and targeting pain-related anxiety among this trauma-exposed segment of the chronic pain population with elevated posttraumatic stress symptoms.

Section snippetsParticipants

Participants were 292 trauma-exposed adults reporting current chronic pain and prescription opioid use (71.6 % female, Mage = 38.03 years, SD = 10.93). Eligibility criteria for the current study included: being between the ages of 18–64 years, reporting current moderate to severe chronic pain that persisted for at least 3 months, reporting current use of opioid medication for pain, and reported exposure to at least 1 traumatic event. Participants were excluded if they were younger than

Descriptive statistics and Bi-Variate correlations

See Table 1 for full descriptive and bi-variate correlations. The PDS total score was significantly positively associated with PASS total score, as well as COMM and SDS total scores. Additionally, the PASS total score was significantly positively associated with COMM and SDS total scores.

Hierarchical regression analyses

Current Opioid Misuse. Step 1 of the model, including covariates only, accounted for a significant proportion of variance in COMM total score (F (4, 287) = 20.61, p < 0.001, R2 = 0.22), and age, male, number of

Discussion

The current study examined the moderating role of pain-related anxiety in the association between posttraumatic stress, opioid misuse, and dependence among trauma-exposed adults with chronic pain. Results from the current study were generally in line with aforementioned hypotheses. Specifically, pain-related anxiety significantly moderated the relationship between posttraumatic stress symptoms and opioid outcomes. The form of the interaction indicated that the relationship between posttraumatic

Author disclosure

Authors Rogers, Garey, and Zvolensky designed the study, wrote the protocol, and conducted data analysis. All authors substantively contributed to the drafting and approval of the manuscript.

No funding was provided for the current study.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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