Personality traits and sensitivity to pain in male chronic opioid addicts

Elon Eisenberg, MD; Doron Cohen, MA; Eli Lawental, PhD; Dorit Pud, PhD

doi:10.5055/jom.2007.0008

Authors

Elon Eisenberg, MD
Doron Cohen, MA
Eli Lawental, PhD
Dorit Pud, PhD

DOI:

https://doi.org/10.5055/jom.2007.0008

Keywords:

addiction, cold pressor test, opioids, pain perception, personality traits

Abstract

Objective: Previous evidences concerning pain mechanisms, long-term opioids use, and personality traits evolve the possibility that pain perception and opioid abuse are two related phenomena and there is a need to take into account the specific personality traits as well, in examining the relationships among them. Opioid addicts (OAs) have been shown to exhibit different personality traits and pain perception as compared with healthy subjects. The aim of the present study was to examine the relations between personality traits and pain perception among in-treatment OAs in comparison with controls.
Design: Participants (54 OAs, 59 controls), all males, were exposed to the cold pressor test and were evaluated for latency of pain onset (seconds); pain intensity (0-100 visual analogue scale [VAS)]); and pain tolerance (time for hand withdrawal). Personality traits were evaluated using Cloninger’s Tridimensional Personality Questionnaire, TPQ; harm avoidance, HA; reward dependence, RD; novelty seeking, NS.
Results: In comparison with controls, OAs exhibited longer latencies, lower VAS scores, and shorter tolerance, and significantly higher NS, higher HA, and lower RD. Control group, but not OAs, showed a significant positive correlation between HA and VAS (r = 0.31, p = 0.02) and significant negative correlation between HA and tolerance (r = −0.29, p = 0.03).
Conclusions: It is concluded that in contrast to healthy population, personality traits, as measured by the TPQ, do not predict pain perception in OAs.

Author Biographies

Elon Eisenberg, MD

Pain Relief Unit, Rambam Medical Center, Haifa, Israel, and The Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel.

Doron Cohen, MA

Haifa Drug Abuse Treatment Center, Rambam Medical Center, Haifa, Israel.

Eli Lawental, PhD

Haifa Drug Abuse Treatment Center, Rambam Medical Center, Haifa, Israel.

Dorit Pud, PhD

Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel.

References

Pud D, Cohen D, Lawental E, et al.: Opioids and abnormal pain perception: New evidence from a study of chronic opioid addicts and healthy subjects. Drug Alcohol Depend. 2006; 82(3): 218-223.

Martin JE, Inglis J: Pain tolerance and addiction. Br J Soc Clin Psychol. 1965; 4: 224-229.

Compton MA: Cold-pressor pain tolerance in opiate and cocaine abusers: Correlates of drug type and use status. J Pain Symptom Manage. 1994; 9: 462-473.

Compton P, Charuvastra VC, Ling W: Pain intolerance in opioid- maintained former opiate addicts: Effect of long-acting maintenance agent. Drug Alcohol Depend. 2001; 63: 139-146.

Doverty M, White JM, Somogyi AA, et al.: Hyperalgesic responses in methadone maintenance patients. Pain. 2001; 90: 91-96.

Doverty M, Somogyi AA, White JM, et al.: Methadone maintenance patients are cross-tolerant to the antinociceptive effects of morphine. Pain. 2001; 93: 155-163.

Sjorgen P, Jonsson T, Jensen NH, et al.: Hyperalgesia and myoclonus in terminal cancer patients treated with continuous intravenous morphine. Pain. 1993; 55: 93-97.

Compton P, Charuvastra VC, Kintaudi K, et al.: Pain Responses in Methadone-Maintained Opioid Abusers. J Pain Symptom Manage. 2000; 20(4): 237-245.

Turk DC: Biopsychosocial perspective on chronic pain. In Gatchel RJ, Turk DC (eds.): Psychological Approaches to Pain Management: A Practitioner’s Handbook. New York: Guilford Press, 1996: 3-34.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC: Author, 1994.

Cloninger CR: A systemic method for clinical description and classification of personality variants. Arch Gen Psychiatry. 1987; 44: 573-587.

Pfohl B, Black D, Noyes R Jr, et al.: A test of the tridimensional personality theory: Association with diagnosis and platelet imipramine binding in obsessive-compulsive disorder. Biol Psychiatry. 1990; 28: 41-46.

Chien AJ, Dunner D: The Tridimensional Personality Questionnaire in depression: State versus trait issues. J Psychiatr Res. 1996; 30: 21-27.

Starcevic V, Vhlenhuth EH, Fallon S, et al.: Personality dimensions in panic disorder and generalized anxiety disorder. J Affect Disord. 1996; 37: 75-79.

Nelson E, Cloninger CR: Exploring the TPQ as a possible predictor of antidepressant response to nefazodone in a large multi-site study. J Affect Disord. 1997; 44: 197-200.

Hansenne M, Pitchot W, Gonzalez-Moreno A, et al.: The Tridimensional Personality Questionnaire (TPQ) and depression. Eur Psychiatry. 1998; 13: 101-103.

Herran A, Vazquez B: Personality dimensions, the TPQ and depression. Eur Psychiatry. 1998; 13: 434.

Gil S: The role of personality traits in the understanding of suicide attempt behavior among psychiatric patients. Arch Suicide Res. 2003; 7: 1-8.

Pud D, Eisenberg E, Sprecher E, et al.: The tridimensional personality theory and pain: Harm avoidance and reward dependence traits correlate with pain perception in healthy volunteers. Eur J Pain. 2004; 8: 31-38.

Granot M: Personality traits associated with perception of noxious stimuli in women with vulvar vestibulitis syndrome. J Pain. 2005; 6(3): 168-173.

Cohen LJ, Gertmenian-King E, Kunik L, et al.: Personality measures in former heroin users receiving methadone or in protracted abstinence from opiates. Acta Psychiatr Scand. 2005; 112: 149-158.

Craig RJ: Prevalence of personality disorders among cocaine and heroin addicts. Subst Abuse. 2000; 21: 87-94.

Ball SA, Cecero JJ: Addicted patients with personality disorders: Traits, schemas, and presenting problems. J Personal Disord. 2001; 15(1): 72-83.

Limson R, Goldman D, Roy A, et al.: Personality and cerebrospinal fluid monoamine metabolites in alcoholics and controls. Arch Gen Psychiatry. 1991; 48: 437-441.

Vukov M, Baba-Milkic N, Lecic D, et al.: Personality dimensions of opiate addicts. Acta Psychiatr Scand. 1995; 91: 103-107.

Howard MO, Kivlahan D, Walker RD: Cloninger’s tridimensional theory of personality and psychopathology: Applications to substance use disorders. J Stud Alcohol. 1997; 58: 48-66.

Van Ammers EC, Seilman JD, Mulder RT: Temperament and substance abuse in schizophrenia: Is there a relationship? J Nerv Ment Dis. 1997; 185: 283-288.

Ball SA, Kranzler HR, Tennen H, et al.: Personality disorders and dimension differences between type A and type B substance abusers. J Personal Disord. 1998; 12: 1-12.

Ball SA, Tennen H, Poling JC, et al.: Personality, temperament and character dimension and the DSM-IV personality disorders in substance abusers. J Abnorm Psychol. 1997; 106: 545-553.

Wills TA, Windle M, Cleary SD: Temperament and novelty seeking in adolescent substance use: Convergence of dimensions of temperament with construct from Cloninger’s theory. J Pers Soc Psychol. 1998; 74: 387-406.

Wills TA, Sandy JM, Shinar O: Cloninger’s constructs related to substance use level and problems in late adolescence: A mediational model based on self-control and coping motives. Exp Clin Psychopharmacol. 1999; 7: 122-134.

Sher KJ, Batholow BD, Wood MD: Personality and substance use disorders: A prospective study. J Consult Clin Psychol. 2000; 68: 818-829.

Helmus TC, Downey KK, Arfken CL, et al.: Novelty seeking as a predictor of treatment retention for heroin dependent cocaine users. Drug Alcohol Depend. 2001; 61: 287-295.

Gerdner A, Nordlander T, Pedersen T: Personality factors and drug of choice in female addicts with psychiatric comorbidity. Subst Use Misuse. 2002; 37(1): 1-18.

Gomez-Peretta De Mateo C, Portoles Sanz M, Perez Diaz MI, et al.: Serotoninergic activity and harm avoidance in abstinent drug addicts. Actas Esp Psiquiatr. 2002; 30: 241-245.

Guiterrez F, Sngorrin J, Martin-Santos R, et al.: Measuring the core features of personality disorders in substance abusers using the temperament and character inventory (TCI). J Personal Disord. 2002; 16: 344-359.

Conway KP, Kane RJ, Ball SA, et al.: Personality, substance choice and polysubstance involvement among substance dependent patients. Drug Alcohol Depend. 2003; 71: 65-75.

Gourion D, Pelissolo A, Lepine JP: Test-retest reliability of the temperament and character inventory in patients with opiate dependence. Psychiatry Res. 2003; 118: 81-88.

Roll JM, Saules KK, Chudzynski JE, et al.: Relationship between Tridimensional Personality Questionnaire scores and clinic attendance among cocaine abusing, buprenorphine maintained outpatients. Subst Use Misuse. 2004; 39: 1025-1040.

Fillingim RB: Sex, gender, and pain: Women and men really are different. Curr Rev Pain. 2000; 4: 24-30.

Wolff BB: Methods of testing pain mechanisms in normal man. In Wall PD, Melzack R (eds.): Textbook of Pain, 2nd Edition. Edinburgh: Churchill Livingstone, 1984: 186-194.

Zohar AH, Lev-Ari L, Benjamin J, et al.: The psychometric properties of the Hebrew version of Cloninger’s TPQ. Pers Individ Dif. 2001; 30: 118-128.

Cloninger CR, Przybeck TR, Svrakic DM: The Tridimensional Personality Questionnaire: U.S. normative data. Psychol Rep. 1991; 69: 1047-1057.

Le Bon O, Basiaux P, Streel E, et al.: Personality profile and drug of choice: A multivariate analysis using Cloninger’s TCI on heroin addicts, alcoholics and a random population group. Drug Alcohol Depend. 2004; 73: 175-182.

Gerra G, Zaimovic A, Timpano M, et al.: Neuroendocrine correlates of temperamental traits in humans. Psychoneuroendocrinology. 2000; 25: 479-496.

Fassino S, Daga AG, Delsedime N, et al.: Quality of life and personality disorders in heroin abusers. Drug Alcohol Depend. 2004; 76(1): 73-80.

Raby WN, Carpenter KM, Aharonovich E, et al.: Temperament characteristics, as assessed by the Tridimensional Personality Questionnaire, moderate the response to sertraline in depressed opiate-dependent methadone patients. Drug Alcohol Depend. 2006; 81(3): 283-292.

Pud D, Yarnitsky D, Sprecher E, et al.: Can personality traits and gender predict the response to morphine? An experimental cold pain study. Eur J Pain. 2006; 10(2): 103-112.

Kreek MJ, Nielsen DA, Butelman ER, et al.: Genetic influences on impulsivity, risk taking, stress responsivity and vulnerability to drug abuse and addiction. Nat Neurosci. 2005; 8(11): 1450-1457.

Harris G, Rollman GB: The validity of experimental pain measures. Pain. 1983; 17: 369-376.