Centralized pain and pain catastrophizing mediate the association between lifetime abuse history and self-reported pain medication side effects
| Autor: | Jill Schneiderhan, Jude Divers, Afton L. Hassett, Jenna Goesling, Jennifer Pierce, Chad M. Brummett |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Fibromyalgia Pain medicine Pain medication Pain Young Adult Surveys and Questionnaires medicine Humans Psychiatry Aged Aged 80 and over Analgesics business.industry Catastrophization Stressor Sex Offenses Chronic pain Pain Perception General Medicine Middle Aged medicine.disease Anesthesiology and Pain Medicine Pain Clinics Cross-Sectional Studies Sexual abuse Physical Abuse Pain catastrophizing Female business Medication Discontinuation |
| Zdroj: | Regional anesthesia and pain medicine. 45(4) |
| ISSN: | 1532-8651 |
| Popis: | BackgroundSelf-reported side effects of pain medication are important determinants of treatment course that can affect patient adherence, medication discontinuation and physician decisions. Yet, few studies have investigated patient-level predictors of self-reported pain medication side effects. The present study sought to fill this gap by exploring the impact of physical or sexual abuse history on self-reported pain medication side effects and considered a mediation model in which those effects are transmitted through a centralized pain phenotype and pain catastrophizing.MethodsWe conducted a cross-sectional analysis of 3118 patients presenting to a tertiary-care, outpatient pain clinic.ResultsApproximately 15% of the sample (n=479) reported a lifetime history of abuse. Patients with a lifetime history of abuse, particularly abuse that occurred in both childhood and adulthood, reported more pain medication side effects compared with patients reporting no abuse history. Furthermore, path analysis showed that a centralized pain phenotype and pain catastrophizing mediated the association between lifetime abuse history and the sum of pain medication side effects.ConclusionsThis suggests that individuals who experience abuse may develop a heightened physiological sensitivity to stimuli, as well as a tendency to interpret stimuli negatively, exaggerate the impact of aversive stimuli and undermine their ability to cope with the stressor. This study highlights the need for physicians to understand patient-level predictors of medication tolerance and to consider a history of abuse and trauma in decisions regarding treatment and medication management. |
| Databáze: | OpenAIRE |
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