Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation

Abstract

Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study investigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD.

Emotion regulation in substance use disorders: a systematic review and meta‐analysis

“…We found 36 papers that were eligible for full‐text review. Of these, 14 failed to meet inclusion criteria [ 16 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]; reasons for study exclusion can be found in Supporting information, Table S1.1 . We were left with 22 studies to be included for the primary analysis [ 17 , 27 , 33 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ].…”

“…A summary of the secondary review process is shown in Supporting information, Figure S1 . We excluded 34 studies that failed to meet the inclusion criteria [ 16 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ]; reasons for study exclusion can be found in Supporting information, Table S1.2 .…”

“…We found 36 papers that were eligible for full-text review. Of these, 14 failed to meet inclusion criteria [16,[34][35][36][37][38][39][40][41][42][43][44][45][46]; reasons for study exclusion can be found in Supporting information, Table S1.1. We were left with 22 studies to be included for the primary analysis [17,27,33,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65].…”

“…A summary of the secondary review process is shown in Supporting information, Figure S1. We excluded 34 studies that failed to meet the inclusion criteria [16,[34][35][36][37][38][39][40][41][42][43][44][45][46][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85]; reasons for study exclusion can be found in Supporting information, Table S1.2.…”

2-Arachodonoylglycerol-mediated endocannabinoid signaling modulates mechanical hypersensitivity associated with alcohol withdrawal in mice

“…Importantly, neurotoxic effects of alcohol can result in alcoholic neuropathy after chronic use. Furthermore, alcohol withdrawal is associated with the emergence of hyperalgesia [9][10][11][12][13] and allodynia which can persist after weeks or months of abstinence [10]. Moreover, this effect is seen in patients who are alcohol dependent but report no preexisting chronic or acute pain conditions.…”