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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

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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.

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Authors and Affiliations

  1. Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA

    Michael J. Zvolensky, Andrew H. Rogers, Lorra Garey, Justin M. Shepherd, Andres G. Viana & Brooke Y. Kauffman

  2. Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, USA

    Michael J. Zvolensky

  3. HEALTH Institute, University of Houston, Houston, USA

    Michael J. Zvolensky

  4. Department of Psychology, Syracuse University, Syracuse, USA

    Joseph W. Ditre

  5. Texas Institute of Measurement, Evaluation, and Statistics, Houston, USA

    Andres G. Viana

  6. Oklahoma Health Sciences, Oklahoma City, USA

    Michael Businelle

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  1. Michael J. Zvolensky
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Zvolensky, M.J., Rogers, A.H., Garey, L. et al. The Role of Anxiety Sensitivity in the Relation Between Pain Intensity with Substance Use and Anxiety and Depressive Symptoms Among Smokers with Chronic Pain. Int.J. Behav. Med. 27, 668–676 (2020). https://doi.org/10.1007/s12529-020-09914-4

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