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Adverse childhood experiences predict autonomic indices of emotion dysregulation and negative emotional cue-elicited craving among female opioid-treated chronic pain patients

Published online by Cambridge University Press:  07 May 2019

Eric L. Garland ,
Sarah E. Reese ,
Carter E. Bedford  and
Anne K. Baker
Eric L. Garland*
Affiliation:
College of Social Work and Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
Sarah E. Reese
Affiliation:
College of Social Work and Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
Carter E. Bedford
Affiliation:
College of Social Work and Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
Anne K. Baker
Affiliation:
College of Social Work and Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
*
Author for Correspondence: Eric L. Garland, 395 South, 1500 East, University of Utah, Salt Lake City, UT 84112; E-mail: elgarlan@gmail.com.
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Abstract

Through autonomic and affective mechanisms, adverse childhood experiences (ACEs) may disrupt the capacity to regulate negative emotions, increasing craving and exacerbating risk for opioid use disorder (OUD) among individuals with chronic pain who are receiving long-term opioid analgesic pharmacotherapy. This study examined associations between ACEs, heart rate variability (HRV) during emotion regulation, and negative emotional cue-elicited craving among a sample of female opioid-treated chronic pain patients at risk for OUD. A sample of women (N = 36, mean age = 51.2 ± 9.5) with chronic pain receiving long-term opioid analgesic pharmacotherapy (mean morphine equivalent daily dose = 87.1 ± 106.9 mg) were recruited from primary care and pain clinics to complete a randomized task in which they viewed and reappraised negative affective stimuli while HRV and craving were assessed. Both ACEs and duration of opioid use significantly predicted blunted HRV during negative emotion regulation and increased negative emotional cue-elicited craving. Analysis of study findings from a multiple-levels-of-analysis approach suggest that exposure to childhood abuse occasions later emotion dysregulation and appetitive responding toward opioids in negative affective contexts among adult women with chronic pain, and thus this vulnerable clinical population should be assessed for OUD risk when initiating a course of extended, high-dose opioids for pain management.

Keywords

emotion regulationheart rate variabilityopioid use disorderreappraisaltrauma
Type
Special Issue Articles
Information
Development and Psychopathology , Volume 31 , Special Issue 3: Emotion Dysregulation and Emerging Psychopathology , August 2019 , pp. 1101 - 1110
Copyright
Copyright © Cambridge University Press 2019 

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