{"title":"探讨不确定性耐受对慢性疼痛和酒精使用障碍患者疼痛耐受性和渴望的调节作用。","authors":"Milena Radoman , Emily Heilner , Colleen McGowan , Benazir Neree-Thompson , Elcin Sakmar , Rajita Sinha","doi":"10.1016/j.alcohol.2025.06.001","DOIUrl":null,"url":null,"abstract":"<div><div>Chronic pain (CP) and alcohol use disorder (AUD) frequently co-occur, yet the psychological factors underlying their interaction remain unclear. Intolerance of uncertainty (IU) – a cognitive trait linked to distress in unpredictable situations – may influence pain management and coping behaviors in these populations. This study examined whether IU moderates pain and alcohol craving responses to a pain-related stressor in individuals with CP and AUD. Fifty-five adults aged 18–65 years were enrolled, including individuals with CP only (n = 20), AUD only (n = 14), CP + AUD (n = 8), and healthy controls (n = 13). Participants completed a self-report measure of IU and the Yale Pain Stress Test (YPST), an adaptation of the Cold Pressor Test, designed to elicit pain-related stress. Behavioral pain tolerance, subjective pain and alcohol craving were assessed across two experimental sessions, one with exposure to an ice-cold water stressor and the second with a warm-water control condition. Exposure to the pain-related stressor significantly reduced behavioral pain tolerance and increased subjective pain across all groups, and also heightened alcohol craving, particularly in individuals with AUD. IU moderated the pain experience during pain-related stress: in the CP + AUD group, higher IU was associated with lower pain tolerance, whereas in the AUD group, higher IU was correlated with greater pain tolerance. IU also moderated craving responses, with higher IU predicting increased craving in individuals with both CP and AUD. These preliminary findings highlight IU as a potential treatment target, suggesting that interventions aimed at improving uncertainty tolerance may enhance pain coping and reduce stress-driven alcohol-seeking behaviors in vulnerable populations.</div></div>","PeriodicalId":7712,"journal":{"name":"Alcohol","volume":"127 ","pages":"Pages 55-61"},"PeriodicalIF":2.5000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Examining the moderating role of intolerance of uncertainty on pain tolerance and craving in patients with chronic pain and alcohol use disorder\",\"authors\":\"Milena Radoman , Emily Heilner , Colleen McGowan , Benazir Neree-Thompson , Elcin Sakmar , Rajita Sinha\",\"doi\":\"10.1016/j.alcohol.2025.06.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Chronic pain (CP) and alcohol use disorder (AUD) frequently co-occur, yet the psychological factors underlying their interaction remain unclear. Intolerance of uncertainty (IU) – a cognitive trait linked to distress in unpredictable situations – may influence pain management and coping behaviors in these populations. This study examined whether IU moderates pain and alcohol craving responses to a pain-related stressor in individuals with CP and AUD. Fifty-five adults aged 18–65 years were enrolled, including individuals with CP only (n = 20), AUD only (n = 14), CP + AUD (n = 8), and healthy controls (n = 13). Participants completed a self-report measure of IU and the Yale Pain Stress Test (YPST), an adaptation of the Cold Pressor Test, designed to elicit pain-related stress. Behavioral pain tolerance, subjective pain and alcohol craving were assessed across two experimental sessions, one with exposure to an ice-cold water stressor and the second with a warm-water control condition. Exposure to the pain-related stressor significantly reduced behavioral pain tolerance and increased subjective pain across all groups, and also heightened alcohol craving, particularly in individuals with AUD. IU moderated the pain experience during pain-related stress: in the CP + AUD group, higher IU was associated with lower pain tolerance, whereas in the AUD group, higher IU was correlated with greater pain tolerance. IU also moderated craving responses, with higher IU predicting increased craving in individuals with both CP and AUD. These preliminary findings highlight IU as a potential treatment target, suggesting that interventions aimed at improving uncertainty tolerance may enhance pain coping and reduce stress-driven alcohol-seeking behaviors in vulnerable populations.</div></div>\",\"PeriodicalId\":7712,\"journal\":{\"name\":\"Alcohol\",\"volume\":\"127 \",\"pages\":\"Pages 55-61\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alcohol\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0741832925000801\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alcohol","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0741832925000801","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Examining the moderating role of intolerance of uncertainty on pain tolerance and craving in patients with chronic pain and alcohol use disorder
Chronic pain (CP) and alcohol use disorder (AUD) frequently co-occur, yet the psychological factors underlying their interaction remain unclear. Intolerance of uncertainty (IU) – a cognitive trait linked to distress in unpredictable situations – may influence pain management and coping behaviors in these populations. This study examined whether IU moderates pain and alcohol craving responses to a pain-related stressor in individuals with CP and AUD. Fifty-five adults aged 18–65 years were enrolled, including individuals with CP only (n = 20), AUD only (n = 14), CP + AUD (n = 8), and healthy controls (n = 13). Participants completed a self-report measure of IU and the Yale Pain Stress Test (YPST), an adaptation of the Cold Pressor Test, designed to elicit pain-related stress. Behavioral pain tolerance, subjective pain and alcohol craving were assessed across two experimental sessions, one with exposure to an ice-cold water stressor and the second with a warm-water control condition. Exposure to the pain-related stressor significantly reduced behavioral pain tolerance and increased subjective pain across all groups, and also heightened alcohol craving, particularly in individuals with AUD. IU moderated the pain experience during pain-related stress: in the CP + AUD group, higher IU was associated with lower pain tolerance, whereas in the AUD group, higher IU was correlated with greater pain tolerance. IU also moderated craving responses, with higher IU predicting increased craving in individuals with both CP and AUD. These preliminary findings highlight IU as a potential treatment target, suggesting that interventions aimed at improving uncertainty tolerance may enhance pain coping and reduce stress-driven alcohol-seeking behaviors in vulnerable populations.
期刊介绍:
Alcohol is an international, peer-reviewed journal that is devoted to publishing multi-disciplinary biomedical research on all aspects of the actions or effects of alcohol on the nervous system or on other organ systems. Emphasis is given to studies into the causes and consequences of alcohol abuse and alcoholism, and biomedical aspects of diagnosis, etiology, treatment or prevention of alcohol-related health effects.
Intended for both research scientists and practicing clinicians, the journal publishes original research on the neurobiological, neurobehavioral, and pathophysiological processes associated with alcohol drinking, alcohol abuse, alcohol-seeking behavior, tolerance, dependence, withdrawal, protracted abstinence, and relapse. In addition, the journal reports studies on the effects alcohol on brain mechanisms of neuroplasticity over the life span, biological factors associated with adolescent alcohol abuse, pharmacotherapeutic strategies in the treatment of alcoholism, biological and biochemical markers of alcohol abuse and alcoholism, pathological effects of uncontrolled drinking, biomedical and molecular factors in the effects on liver, immune system, and other organ systems, and biomedical aspects of fetal alcohol spectrum disorder including mechanisms of damage, diagnosis and early detection, treatment, and prevention. Articles are published from all levels of biomedical inquiry, including the following: molecular and cellular studies of alcohol''s actions in vitro and in vivo; animal model studies of genetic, pharmacological, behavioral, developmental or pathophysiological aspects of alcohol; human studies of genetic, behavioral, cognitive, neuroimaging, or pathological aspects of alcohol drinking; clinical studies of diagnosis (including dual diagnosis), treatment, prevention, and epidemiology. The journal will publish 9 issues per year; the accepted abbreviation for Alcohol for bibliographic citation is Alcohol.