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Author(s): Andrew H. Rogers [sup.1] , Luke F. Heggeness [sup.1] , Tanya Smit [sup.1] , Michael J. Zvolensky [sup.1] [sup.2] [sup.3] Author Affiliations: (1) https://ror.org/048sx0r50, grid.266436.3, 0000 0004 1569 9707, [...], Chronic low back pain (CLBP) is a significant public health problem that is associated with opioid misuse and use disorder. Despite limited evidence for the efficacy of opioids in the management of chronic pain, they continue to be prescribed and people with CLBP are at increased risk for misuse. Identifying individual difference factors involved in opioid misuse, such as pain intensity as well as reasons for using opioids (also known as motives), may provide pertinent clinical information to reduce opioid misuse among this vulnerable population. Therefore, the aims of the current study were to examine the relationships between opioid motives-to cope with pain-related distress and pain intensity, in terms of anxiety, depression, pain catastrophizing, pain-related anxiety, and opioid misuse among 300 (M.sub.age= 45.69, SD = 11.17, 69% female) adults with CLBP currently using opioids. Results from the current study suggest that both pain intensity and motives to cope with pain-related distress with opioids were associated with all criterion variables, but the magnitude of variance explained by coping motives was larger than pain intensity in terms of opioid misuse. The present findings provide initial empirical evidence for the importance of motives to cope with pain-related distress with opioids and pain intensity in efforts to better understand opioid misuse and related clinical correlates among adults with CLBP.

Author(s): Andrew H. Rogers [sup.1] , Michael J. Zvolensky [sup.1] [sup.2] [sup.3] , Anka A. Vujanovic [sup.1] , Camilo J. Ruggero [sup.4] , Joshua Oltmanns [sup.5] , Monika A. Waszczuk [...], Chronic pain is a significant public health problem and is exacerbated by stress. The World Trade Center (WTC) Disaster represents a unique stressor, and responders to the WTC disaster are at increased risk for pain and other health complaints. Therefore, there is a significant need to identify vulnerability factors for exacerbated pain experience among this high-risk population. Anxiety sensitivity (AS), defined as fear of anxiety-related sensations, is one such vulnerability factor associated with pain intensity and disability. Yet, no work has tested the predictive effects of AS on pain, limiting conclusions regarding the predictive utility and direction of associations. Therefore, the current study examined the prospective associations of AS, pain intensity, and pain interference among 452 (M.sub.age = 55.22, SD = 8.73, 89.4% male) responders to the WTC disaster completing a 2-week daily diary study. Using multi-level modeling, AS total score was positively associated with both pain intensity and pain interference, and that AS cognitive concerns, but not social or physical concerns, were associated with increased pain. These results highlight the importance of AS as a predictor of pain complaints among WTC responders and provide initial empirical evidence to support AS as a clinical target for treating pain complaints among WTC responders.

Author(s): Michael J. Zvolensky [sup.1] [sup.2] [sup.3] , Tanya Smit [sup.1] , Andrew H. Rogers [sup.1] , Cameron Matoska [sup.1] , Lorra Garey [sup.1] , Andres G. Viana [sup.1] , [...], The Latinx population is the largest minority group in the United States (U.S.) and is expected to continue to grow through at least 2050. Although there is growing recognition of the importance of pain among Latinx individuals, few studies have examined individualized psychological processes governing pain severity and disability in Latinx populations. One psychological factor that has shown promise in relation to pain experience specifically and clinical conditions more generally is anxiety sensitivity. The present investigation sought to (1) characterize the severity of pain among an unselected sample of adult Latinx individuals attending a Federally Qualified Health Center (FQHC); (2) evaluate the severity of anxiety sensitivity as a function of pain severity; and (3) test the potential explanatory relevance of anxiety sensitivity as an individual difference factor for pain intensity, pain disability, psychological inflexibility for emotional distress, and global life impairment. Participants included 406 adult Spanish-speaking Latinx persons (87.2% female; M.sub.age = 40.26 years, SD = 11.20, and 98.3% used Spanish as their first language) who attended an FQHC in Houston, Texas. Analyses revealed that 62.6% of the sample had at least some pain, and 21.9% of the same had high intensity, moderate interference, or severe interference chronic pain. Further, results provided evidence for anxiety sensitivity as a function of pain grade, such that individuals with grade 2 (high-intensity pain), grade 3 (moderate pain interference), and grade 4 (severe pain interference) chronic pain reported significantly higher levels of anxiety sensitivity than those with grade 0 pain (no chronic pain). Additionally, after controlling for age, gender, marital status, years of education, years living in the U.S., and generalized anxiety, anxiety sensitivity significantly accounted for significant variance in pain intensity, inflexibility in relation to emotional distress, and life impairment. Overall, the current study builds upon what is currently understood about anxiety sensitivity among the Latinx population and uniquely extends past work by linking individual differences in this construct to clinically relevant aspects of pain experience and life impairment among adults attending FQHC's. Additional clinical attention should be focused on anxiety sensitivity to offset pain disparities among this established health disparities group.

Author(s): Brooke Y. Kauffman [sup.1] , Ryan Kroeger [sup.1] , Andrew H. Rogers [sup.1] , Lorra Garey [sup.1] , Joseph W. Ditre [sup.2] , Michael J. Zvolensky [sup.1] [sup.3] [sup.4] [...], Chronic pain is often comorbid with modifiable cardiovascular disease risk factors, such as obesity and tobacco use. Among individuals with chronic pain, psychological risk factors may increase pain which, in turn, may increase risk for modifiable cardiovascular disease correlates. Thus, the current study examined the explanatory role of pain intensity in the relationship between anxiety sensitivity and two well-documented modifiable cardiovascular disease risk factors. Participants included 396 adults with chronic pain who completed an online survey from a larger study examining chronic pain-mental health relations. Results revealed that higher levels of anxiety sensitivity were related to higher levels of body mass index (BMI) through greater levels of pain intensity. Bi-directional relations were observed between anxiety sensitivity and pain intensity for tobacco risk. The current study highlights a potential transdiagnostic cognitive vulnerability factor, anxiety sensitivity, which may be an important treatment target to reduce modifiable cardiovascular disease risk factors via reductions in pain intensity.

Author(s): Andrew H. Rogers [sup.1] , Michael F. Orr [sup.1] , Justin M. Shepherd [sup.1] , Jafar Bakhshaie [sup.2] , Joseph W. Ditre [sup.3] , Julia D. Buckner [sup.4] , [...], The opioid epidemic is a significant public health concern in the United States, particularly among adults with chronic pain. Considerable research suggests that people with mental health problems, including anxiety and depression, may experience more opioid-related problems in the context of chronic pain. Yet, little work has examined potential mechanisms underyling these relations. Emotion dysregulation is one mechanistic factor that may link anxiety and depression and opioid-related problems among persons with chronic pain. Therefore, the current study examined the explanatory role of emotion dysregulation in the cross-sectional relationship between anxiety and depression problems and current opioid misuse and severity of opioid dependence among 431 adults with chronic pain who reported currently using opioid medications (74% female, M.sub.age=38.32 years, SD = 11.11). Results indicated that emotion dysregulation explained, in part, the relationship between anxiety and depression symptoms and opioid-related problems. These findings highlight the need to further consider the role of emotion dysregulation among adults with chronic pain who use prescription opioids and experience symptoms of anxiety or depression. Future prospective research will be needed to further establish emotion dysregulation as a mechanism in anxiety/depression-opioid misuse/dependence processes.

Author(s): Michael J. Zvolensky [sup.1] [sup.2] [sup.3] , Andrew H. Rogers [sup.1] , Justin M. Shepherd [sup.1] , Anka A. Vujanovic [sup.1] , Jafar Bakhshaie [sup.1] Author Affiliations: (1) grid.266436.3, [...], It is unclear if anxiety sensitivity may serve as mechanism underlying the relation between posttraumatic stress symptom severity and opioid misuse and dependence among trauma-exposed persons with chronic pain. Therefore, the current study evaluated the explanatory role of anxiety sensitivity in the relations between posttraumatic stress symptom severity and opioid misuse and dependence. Participants included 294 trauma-exposed adults with chronic pain (71.4% female, M.sub.age = 37.79 years, SD = 10.85, M.sub.pain rating = 7.32/10) that reported current moderate to severe chronic pain and prescription opioid use. Participants were recruited via an online national survey in the United States of America. There were statistically significant indirect effects of posttraumatic stress symptom severity via anxiety sensitivity in relation to opioid misuse and dependence. The indirect effects of the reverse models for opioid misuse and dependence also were significant and suggest the potential for bi-directional relations; however, the magnitude of the effect was smaller in the tests of specificity than in the original models. The present findings provide initial empirical evidence that greater posttraumatic stress symptom severity is related to anxiety sensitivity, which in turn, is associated with increased opioid misuse and dependence among trauma-exposed individuals with chronic pain.

Author(s): Michael J. Zvolensky [sup.1] [sup.2] [sup.3] , Lorra Garey [sup.1] , Nubia A. Mayorga [sup.1] , Andrew H. Rogers [sup.1] , Michael F. Orr [sup.1] , Joseph W. Ditre [...], The present study examined past-month pain severity in relation to e-cigarette dependence, perceived barriers for quitting e-cigarettes, and beliefs about risks associated with using e-cigarettes. Participants were 322 e-cigarette users from the United States (60.2% female, M.sub.age= 36.78 years, SD = 10.62). Results indicated that pain severity was significantly and positively related to e-cigarette dependence, perceived risks of e-cigarette use, and perceived barriers to quitting e-cigarettes. The observed effects were evident above and beyond the variance accounted for by sex, age, education, income, dual cigarette use, frequency of e-cigarette use, and perceived health status. The present study provides novel empirical evidence that pain experience is related to a moderate, yet clinically-meaningful, proportion of the variance in e-cigarette dependence, perceived barriers for quitting e-cigarettes, and beliefs about e-cigarette risks. These findings suggest there is merit to exploring the role of pan experience in the onset and maintenance of e-cigarette use.

Background Chronic pain is a significant public health problem that is associated with several negative health outcomes, including increased health care cost, decreased productivity, and prescription opioid misuse. Although efforts have been made to curb the growing opioid epidemic in the United States, further research is needed to better understand individual difference factors that may be associated with greater pain and opioid misuse. Lower levels of health literacy, defined as the ability to obtain, understand, and use health information to make important decisions regarding health and medical care, has been associated with several chronic illnesses. Yet little work has examined the relationship between health literacy, pain, and opioid misuse among individuals with chronic pain. Methods The current study examined health literacy in relation to current opioid misuse, severity of opioid dependence, pain severity, and pain disability among 445 adults with chronic pain (74.6% female, Mage [SD] = 38.45 [11.06] years). Results Results indicated that health literacy was significantly negatively associated with each of the criterion variables. Conclusions These results suggest that health literacy may contribute to opioid misuse and pain experience among individuals with chronic pain. Interventions targeting health literacy among individuals with chronic illness may help to address the opioid public health crisis. [ABSTRACT FROM AUTHOR]

The present study examined past-month pain severity in relation to e-cigarette dependence, perceived barriers for quitting e-cigarettes, and beliefs about risks associated with using e-cigarettes. Participants were 322 e-cigarette users from the United States (60.2% female, Mage= 36.78 years, SD = 10.62). Results indicated that pain severity was significantly and positively related to e-cigarette dependence, perceived risks of e-cigarette use, and perceived barriers to quitting e-cigarettes. The observed effects were evident above and beyond the variance accounted for by sex, age, education, income, dual cigarette use, frequency of e-cigarette use, and perceived health status. The present study provides novel empirical evidence that pain experience is related to a moderate, yet clinically-meaningful, proportion of the variance in e-cigarette dependence, perceived barriers for quitting e-cigarettes, and beliefs about e-cigarette risks. These findings suggest there is merit to exploring the role of pan experience in the onset and maintenance of e-cigarette use. [ABSTRACT FROM AUTHOR]

Background: Opioids are effective for acute pain management following surgery among adolescents, yet are associated with significant negative consequences, including respiratory depression and opioid misuse. Sleep deficiency is common following surgery and extant research indicates strong cross-sectional associations between sleep deficiency and increased problematic opioid use., Objective: This study examined longitudinal associations between postsurgical sleep deficiency and opioid use among adolescents undergoing outpatient surgery. We also examined daily pain and mood as mechanisms linking previous night's sleep deficiency and next day prescription opioid use., Methods: This prospective, observational study enrolled 106 adolescents (11-19 years) who underwent orthopedic outpatient surgery and collected pre-surgery and longitudinal measurements. Participants were 52% female, African-American (7%), American Indian/Alaska Native (7%), Hispanic (9%), Native Hawaiian or Other Pacific Islander (4%), or white, non-Hispanic (66%). Using ecological momentary assessment methods, participants reported sleep, pain, and mood in real time over the first 14 days following surgery. Postsurgical opioid use was measured using an electronic medication cap monitoring device, eCAP TM . Associations between variables were measured using multilevel structural equation modeling., Results: Using multi-level mediation models, pain, but not mood-mediated associations between postsurgical sleep deficiency (sleep quality, total sleep time, sleep onset latency, and wake after sleep onset) and opioid use, at both the within-person and between-person levels. Results highlight that greater previous night's sleep deficiency (both generally and greater than a person's mean level) was associated with higher next day pain (both generally and greater than a person's mean level), which, in turn, was associated with higher opioid use. Furthermore, between-person total effect models provide support for sleep deficiency predicting higher opioid use., Conclusions: Our findings should be considered preliminary yet underscore the need for a comprehensive and personalized approach to postsurgical pain management and opioid use, potentially implementing interventions targeting sleep quality and quantity to reduce pain and opioid use., (© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)