Surgical incision pain induced an increase in alcohol consumption in mice.

INTRODUCTION: Large population-based studies have suggested a link between increased alcohol use and reduced pain. In addition, these studies suggest that higher levels of pain intensity are associated with an increase in alcohol consumption and rates of hazardous drinking which potentiates the risk of developing alcohol use disorders (AUD). The mechanisms and determinants of the alcohol-pain interaction can be studied in preclinical studies. METHODS: The overall goal of this study is to use animal models to explore the impact of acute postoperative pain on alcohol intake. To achieve this, we characterized the timeline and levels of alcohol intake and preference in mice after laparotomy in the 2-bottle choice paradigm. RESULTS: Our results show that laparotomy surgery increased alcohol intake and preference in male mice but not females in the 2-bottle choice and 3-bottle choice assays. In addition, ketoprofen administration blocked the increase in alcohol consumption in male mice after laparotomy. We also found that changes in alcohol initial sensitivity and acute functional tolerance, using loss of righting reflex (LORR) response, occur after surgery in mice. CONCLUSION: Taken together, these findings suggests that sex, pain and alcohol sensitivity-related factors may modulate the relationship between alcohol consumption and pain.

Pain Intensity, Pain-Related Anxiety, and Hazardous Drinking Among Individuals With PTSD.

OBJECTIVE: Evidence suggests that pain intensity may be indirectly linked to hazardous drinking and PTSD symptom severity via pain-related anxiety. The goal of this analysis was to test the hypotheses in a population with PTSD symptoms that pain intensity would be positively and indirectly associated with hazardous drinking, alcohol dependence, alcohol-related problems, and PTSD symptom severity via pain-related anxiety. METHODS: Heavy drinkers with probable PTSD were recruited via Qualtrics panels (N = 371, 53% Female, Mage = 39.68, SD = 10.86). Linear regression and conditional process models were conducted to examine indirect associations between pain intensity and primary outcomes via pain-related anxiety. RESULTS: Pain intensity was found to be indirectly associated with hazardous drinking, alcohol dependence, alcohol-related problems, and PTSD symptom severity via greater pain-related anxiety. CONCLUSION: These initial findings suggest that pain-related anxiety may play an important role in relations between the experience of pain and hazardous patterns of alcohol consumption among individuals with probable PTSD. Future research is needed to determine the temporal nature of these associations and to examine the potential utility of treatments that address pain-related anxiety in the context of comorbid pain, PTSD, and hazardous drinking.

Combustible cigarette smokers versus e-cigarette dual users among Latinx individuals: Differences in alcohol and drug use severity.

The Latinx population in the United States (U.S.) experiences significant tobacco and other substance use-related health disparities. Yet, little is known about the couse of combustible cigarettes and e-cigarettes (dual use) in relation to substance use behavior among Latinx smokers. The present investigation compared English-speaking Latinx adults living in the United States who exclusively smoke combustible cigarettes versus dual users in terms of alcohol use and other drug use problem severity. Participants were 297 Hispanic/Latinx daily cigarette smokers (36.4% female, Mage = 35.9 years, SD = 8.87) recruited nationally across the United States using Qualtrics Panels to complete self-report measures of behavioral health outcomes. Five analysis of covariance models were conducted to evaluate differences in overall alcohol consumption, dependence, related problems, hazardous drinking, and drug use problem severity between exclusive combustible cigarette smokers (N = 205) and dual users (N = 92). Results indicated that dual users evinced greater levels of alcohol consumption, dependence, alcohol-related problems, and hazardous drinking compared to exclusive combustible cigarette smokers (ps < .001). Dual users also reported greater levels of drug use problems relative to exclusive combustible cigarette smokers (p < .001). The current findings are among the first to document that dual cigarette and e-cigarette use status (compared to exclusive combustible cigarette smoking) may serve as a clinically relevant risk indicator for a range of deleterious substance use problems among Latinx individuals. Future research is needed to corroborate these findings and examine dual-use status as a longitudinal predictor of alcohol and other substance-related problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Pain Severity in Relation to Smoking Cessation Problems and Self-Efficacy for Quitting among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination.

Background: Latinx individuals experience significant tobacco cigarette smoking-related diseases and illnesses. Although most Latinx smokers report a desire to quit smoking, evidenced-based cessation treatments are underutilized in this group, which may partially be due to lower likelihood of receiving advice from a healthcare professional. Further, there are a lack of cessation treatments that account for comorbid symptoms/conditions (e.g., co-occurring pain) and social determinants of health (e.g., perceived discrimination). Extant work has established the reciprocal relation between pain and smoking trajectories. Additionally, although social determinants, such as perceived racial/ethnic discrimination, have demonstrated clinical relevance to a variety of health-related behaviors, limited work has examined the role of perceived discrimination in pain-smoking relations. The current study examined the effects of perceived discrimination and pain severity in relation to smoking cessation problems and self-efficacy for quitting among Latinx cigarette smokers. Method: Participants included 226 (Mage = 34.95 years, SD = 8.62; 38.5% female) adult Latinx daily cigarette smokers. Results: Results indicated that the interaction of pain and perceived discrimination was predictive of greater quit problems (p = 0.041) as well as greater confidence in the ability to refrain from smoking in response to internal (p < 0.001) and external stimuli (p < 0.001). Conclusions: Overall, this work provides a more nuanced understanding of the psychosocial contexts in which Latinx smokers may encounter problems related to quitting, and this data is important for future smoking cessation research and treatment.

Pain interference among adult dual combustible and electronic tobacco users in terms of perceived barriers for quitting.

Electronic cigarette (e-cigarette) use has become increasingly common among combustible cigarette users, and dual use may represent a more severe type of nicotine addiction. Experiencing pain is one prevalent domain that may be important to understand quit processes and behavior among dual users. Although most past research on pain and nicotine/tobacco has focused on combustible cigarette use, initial work on e-cigarette users has found that greater pain severity is associated with higher levels of dependence and negative thinking patterns about e-cigarette use. Yet, there has been no effort to explore the experience of pain among dual users in terms of perceived barriers for quitting combustibles or e-cigarettes. The present study sought to examine pain interference among dual combustible and e-cigarette users in terms of perceived barriers for quitting among 138 (45.9% female; Mage = 35.96 years, SD = 7.16) adult dual users (i.e., users of both combustible cigarette and e-cigarettes). Hierarchical linear regression models indicated that pain interference was significantly associated with both perceived barriers for cessation of combustible cigarettes and perceived barriers for cessation of e-cigarettes. Overall, the present investigation served as an initial evaluation of the role of pain interference in terms of perceived barriers for quitting combustible and e-cigarettes among adult daily dual users. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Role of Pain Avoidance in the Relation between Pain Intensity and Smoking Cessation Processes.

Scientific evidence suggests that smokers who experience varying levels of pain are more likely to maintain their addiction to tobacco. The relationship between pain intensity and cognitive-based smoking processes within a mechanistic framework has received relatively little attention. Pain avoidance may influence the association between pain intensity and smoking, as it is a construct that is related to adverse pain and smoking processes. Thus, the current cross-sectional study examined the indirect effect of pain intensity on three clinically significant smoking processes (i.e., prior quit problems, perceived barriers for cessation, and negative affect reduction smoking expectancies) through pain avoidance among 95 treatment-seeking adult smokers. Regression analyses were conducted using bootstrapping techniques through PROCESS, a conditional modeling program that utilizes an ordinary least squares-based path analytical framework to test for both direct and indirect associations. Results indicated that pain intensity had a statistically significant indirect association with quit problems and perceived barriers for cessation, through pain avoidance. Pain intensity did not have a statistically significant indirect association with the negative affect reduction of smoking expectancies through pain avoidance. The current findings provide evidence for the role of pain avoidance as a potential transdiagnostic mechanism that contributes to maladaptive smoking outcomes within the larger context of the reciprocal model of pain and substance use.

Differences in Pain Severity and Interference between Latinx Combustible Cigarette Smokers and Dual Users with Current Pain.

Latinx individuals who smoke represent a tobacco health disparities group. Yet, limited research has focused on examining dual combustible and electronic cigarette use among Latinx populations. Importantly, Latinx persons who smoke also evince elevated rates of pain problems and symptoms and prior research has consistently linked pain problems and severity to smoking prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among dual combustible cigarette and electronic cigarette Latinx users comparing levels of pain severity and interference. The current sample consists of 196 adult Latinx daily cigarette smokers (35.48 years old; 39.4% female), of which 72 reported current daily dual use of an e-cigarette. Results indicated that Latinx dual users reported greater levels of pain severity (ηp2 = .12) and pain interference (ηp2 = .10) than exclusive combustible cigarette users. The study adds uniquely to the limited literature on the clinical importance of dual cigarette use in relation to pain severity and interference in that pain may serve as an important risk factor for the initiation and maintenance of dual use for increased analgesic nicotine effects.

Initial validation of the expectancies for Benzodiazepine Analgesia Scale.

Chronic pain populations exhibit greater prevalence of benzodiazepine (BZD) prescription (vs. the general population) and greater likelihood of BZD use not as prescribed and dependence symptoms. Individuals report taking BZDs for pain relief, potentially contributing to maintenance/escalation of BZD use and hazardous couse with prescription opioids. Identifying cognitive factors underlying pain-BZD use relations represents a critical step toward understanding the role of pain in BZD use trajectories. Outcome expectancies for substance-related analgesia have been implicated in pain-substance use comorbidity (e.g., alcohol), and there is reason to believe these processes may extend to BZD use. The present study aimed to examine psychometric properties of a newly adapted Expectancies for Benzodiazepine Analgesia (EBA) scale and probe associations between EBA scores and prescription opioid use behaviors. Participants were 306 adults (38.9% females) endorsing chronic pain and current BZD prescription who completed an online survey. Results provided initial support for psychometric validity of the EBA: evidence of single-factor structure with good model fit (Bollen-Stine bootstrap p = .101), excellent internal consistency (α = .93), and evidence of concurrent validity via correlations with pain variables, likelihood of BZD use not as prescribed, BZD dependence symptoms, and self-reported BZD use for pain relief. Exploratory findings among participants prescribed opioids indicated positive covariation between EBA scores and behaviors associated with higher risk opioid use. This is, to our knowledge, the first study to assess analgesia expectancies for BZD use. BZD analgesic expectancies warrant further study as a treatment target in comorbid pain and BZD use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Alcohol use severity in relation to pain severity and interference among latinx adults with current pain who smoke cigarettes.

Limited research has focused expressly on dual tobacco-alcohol use among the Latinx population. Latinx individuals who smoke represent a tobacco health disparities group and evince elevated rates of pain problems and symptoms. Prior research has consistently linked pain problems and severity to smoking and alcohol prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among Latinx persons who smoke and evaluate the role of alcohol use severity in terms of pain severity and interference. The current sample consisted of 228 adult Latinx daily cigarette smokers (Mage = 34.95 years; SD = 8.58; 39.0% female) who endorsed current pain. Results indicated that elevated alcohol use problems were associated with greater levels of pain severity (R2 = 0.06) and interference (R2 = 0.06). The present findings suggest that there may be utility in clinical screening for alcohol use problems among Latinx persons who smoke to offset pain problems among this high-risk group.

Cannabinoid Therapy: Attitudes and Experiences of People With Chronic Pain.

OBJECTIVE: Clinical trials of cannabinoids for chronic pain have mixed and often inconclusive results. In contrast, many prospective observational studies show the analgesic effects of cannabinoids. This survey study aimed to examine the experiences/attitudes of individuals with chronic pain who are currently taking, have previously taken, or never taken cannabinoids for chronic pain to inform future research. METHODS: This study is based on a cross-sectional, web-based survey of individuals with self-reported chronic pain. Participants were invited to participate through an email that was distributed to the listservs of patient advocacy groups and foundations that engage individuals with chronic pain. RESULTS: Of the 969 respondents, 444 (46%) respondents reported currently taking, 213 (22%) previously taken, and 312 (32%) never taken cannabinoids for pain. Participants reported using cannabinoids to treat a wide variety of chronic pain conditions. Those currently taking cannabinoids (vs previously) more frequently reported: (1) large improvements from cannabinoids in all pain types, including particularly difficult-to-treat chronic overlapping pain conditions (eg, pelvic pain), (2) improvements in comorbid symptoms (eg, sleep), and (3) lower interference from side effects. Those currently taking cannabinoids reported more frequent and satisfactory communication with clinicians regarding cannabinoid use. Those never taken cannabinoids reported a lack of suggestion/approval of a clinician (40%), illegality (25%), and lack of FDA regulation (19%) as reasons for never trying cannabinoids. CONCLUSION: These findings underscore the importance of conducting high-quality clinical trials that include diverse pain populations and clinically relevant outcomes that if successful, could support FDA approval of cannabinoid products. Clinicians could then prescribe and monitor these treatments similarly to other chronic pain medications.

Pain Severity and Smoking Abstinence Expectancies among Latinx Individuals Who Smoke Cigarettes: The Moderating Role of Perceived Discrimination.

Latinx individuals experience significant health disparities related to smoking cessation in the United States (US). Although past works have consistently implicated pain in the maintenance of smoking behavior, limited research has examined the role of social determinants (e.g., perceived discrimination) in pain-smoking relations. The current study sought to examine the moderating role of perceived discrimination in the relation between pain severity and smoking abstinence expectancies (i.e., a cognitive factor related to poor smoking outcomes) among 226 Latinx individuals who currently smoke cigarettes (Mage = 34.95 years; SD = 8.62; 38.5% female). The results indicated a statistically significant interaction between pain severity and perceived discrimination with regard to smoking abstinence expectancies (i.e., negative mood, somatic symptoms, harmful consequences, and positive consequences). Post-hoc analyses revealed the association of pain severity and negative mood, harmful consequences, and positive consequences smoking abstinence expectancies evident for individuals with higher perceived discrimination. Moreover, the association between pain severity and somatic symptoms smoking abstinence expectancies was stronger for individuals with higher perceived discrimination. Overall, these results suggest that clinical and community-based public health strategies may benefit from addressing the role of perceived discrimination among Latinx individuals who smoke cigarettes in the context of pain.

Initial Validation of the Intentions to Co-Use Alcohol and Opioids Scale.

Co-use of alcohol and prescription opioid medication increases risk for harmful and potentially fatal health effects (e.g., overdose). Behavioral intentions (i.e., the immediate antecedent of corresponding behavior according to the Theory of Planned Behavior) are important in prediction of substance use, and a valid measure assessing intentions to co-use alcohol and opioids is needed to identify individuals at-risk for harmful substance use. The goal of the current study was to develop and conduct the psychometric validation of a six-item Intentions to Co-Use Alcohol and Opioids (ICAO) scale. Participants included 261 (Mage = 38; 64% male) past-month drinkers with a current opioid prescription and chronic musculoskeletal pain who completed a targeted online survey. Confirmatory factor analysis indicated that a single-factor structure provided good model fit (Bollen-Stine bootstrap p = .121). Moreover, the ICAO demonstrated high internal consistency (α = .96) and was correlated with measures of alcohol and opioid use/co-use. These findings provide support for the single-factor structure, reliability, and concurrent/convergent validity of the ICAO among individuals who endorse alcohol use, opioid use, and chronic musculoskeletal pain. The ICAO may offer clinical utility as a tool to identify individuals at greater risk of potentially fatal co-use of alcohol and opioid medications.

Polygenic risk for alcohol consumption and multisite chronic pain: Associations with ad lib drinking behavior.

Interrelations between alcohol use disorder and chronic pain have received increasing empirical attention, and several lines of evidence support the possibility of shared genetic liability. However, research on the genetic contributions to the component processes of these complex and potentially overlapping phenotypes remains scarce. The goal of the present study was to test polygenic risk scores (PRSs) for alcohol consumption and multisite chronic pain as predictors of ad lib drinking behavior during an experimental taste test. PRSs were calculated for 209 pain-free, moderate-to-heavy drinkers (57.9% male; 63.6% White). Among White participants, the alcohol and chronic pain PRSs showed nominally significant (ps < .05) positive associations with the volume of alcohol consumed and peak blood alcohol concentration (BAC), respectively. However, associations did not survive correction for multiple comparisons. When stratifying results by experimental condition (between-subjects design: no-pain vs. pain), the alcohol PRS was significantly and negatively associated with the volume of alcohol poured, consumed, and peak BAC among Black participants randomized to the no-pain condition (all false discovery rate [FDR]p < .05). Conversely, the chronic pain PRS was significantly and positively associated with study outcomes among White participants in both the no-pain (alcohol consumed; FDRp = .037) and pain conditions (peak BAC; FDRp = .017). These findings lend partial support to the assertion that alcohol consumption in the laboratory is reflective of drinking behavior in naturalistic settings. This was also the first study to use a pain-related PRS to predict alcohol outcomes, which may be indicative of shared etiology between base and target traits. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pain as a causal motivator of alcohol consumption: Associations with gender and race.

Despite accumulating evidence indicating reciprocal interrelations between pain and alcohol consumption, no prior work has examined pain as a proximal antecedent of drinking. The goal of the current study was to test the effects of experimental pain induction on ad-lib alcohol consumption among moderate-to-heavy drinkers without chronic pain (N = 237; 42% female; 37% Black; M = 3.26daily drinks). Participants were randomized to either pain-induction (capsaicin + thermal heat paradigm) or no-pain-control conditions. Experimental pain induction lasted for 15 minutes, during which ad-lib alcohol consumption was assessed using an established taste test paradigm. As hypothesized, results indicated that participants randomized to the pain-induction condition poured and consumed more alcohol and reached a higher peak blood alcohol concentration than those randomized to the no-pain condition (ps < 0.05; ηp² range = 0.018-0.021). Exploratory analyses revealed the effects of pain on alcohol consumption to be most pronounced among participants who self-identified as male or Black (relative to female or White, respectively). These findings indicate that the experience of pain serves as a causal, situational motivator for alcohol consumption, and suggest that current drinkers may be susceptible to escalating their consumption of alcohol in the context of pain. Future research is needed to explicate observed differences in the effects of pain on drinking as a function of gender and race, and to extend this work to individuals with chronic pain and varying levels of alcohol use. Collectively, these findings may help inform the development of integrated treatments to address co-occurring pain and alcohol use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Benzodiazepine Use and Dependence in Relation to Chronic Pain Intensity and Pain Catastrophizing.

Benzodiazepines (BZDs), a class of sedative-hypnotic medications, generated concern as their popularity grew, with particular alarm regarding elevated rates of BZD use among chronic pain populations. Consistent with negative reinforcement/motivational models of substance use, desire for pain alleviation may motivate BZD use. Yet, little is known about relations between pain and addiction-relevant BZD use processes. This cross-sectional survey study aimed to: a) test associations between pain intensity and clinically relevant BZD use patterns, and b) examine the role of pain catastrophizing in hypothesized pain-BZD relations. Participants included 306 adults with chronic musculoskeletal pain and a current BZD prescription who completed an online survey study (Mage = 38.7, 38.9% female). Results indicated that pain intensity was positively associated with past-month BZD use frequency, BZD dependence severity, and likelihood of endorsing BZD misuse behaviors (ps < .05). Pain catastrophizing was positively associated with BZD dependence/likelihood of BZD misuse, covarying for pain intensity (P < .05). These findings build upon an emerging literature by highlighting positive covariation of pain intensity and pain catastrophizing with addiction-relevant BZD use behaviors. Results underscore the need to further investigate high-risk BZD use among individuals with chronic pain, with and without concurrent opioid use, to inform prevention/intervention efforts. PERSPECTIVE: This article presents findings on cross-sectional associations of pain intensity and pain catastrophizing with clinically relevant benzodiazepine (BZD) use outcomes, including dependence and misuse, among individuals with chronic pain. Findings help elucidate the higher burden of BZD misuse/dependence in chronic pain populations and suggest that pain relief may be a common, yet under recognized, self-reported motivation for taking BZDs.

Pain and Menthol Use Are Related to Greater Nicotine Dependence Among Black Adults Who Smoke Cigarettes at Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health (PATH) Study.

Burdens related to pain, smoking/nicotine dependence, and pain-smoking comorbidity disproportionately impact Black Americans, and menthol cigarette use is overrepresented among Black adults who smoke cigarettes. Menthol may increase nicotine exposure, potentially conferring enhanced acute analgesia and driving greater dependence. Therefore, the goal of the current study was to examine associations between pain, menthol cigarette use, and nicotine dependence. Data was drawn from Black adults who were current cigarette smokers (n = 1370) at Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health Study. Nicotine dependence was assessed using the Wisconsin Inventory of Smoking Dependence Motives. ANCOVA revealed that moderate/severe pain (vs. no/low pain) was associated with greater overall nicotine dependence (p < .001) and greater negative reinforcement, cognitive enhancement, and affiliative attachment smoking motives (ps < .001). Menthol smokers with moderate/severe pain also endorsed greater cigarette craving and tolerance, compared to non-menthol smokers with no/low pain (ps < .05). Findings support the notion that among Black individuals who smoke cigarettes, the presence of moderate/severe pain (vs. no/low pain) and menthol use may engender greater physical indices of nicotine dependence relative to non-menthol use. Compared to no/low pain, moderate/severe pain was associated with greater emotional attachment to smoking and greater proclivity to smoke for reducing negative affect and enhancing cognitive function. Clinical implications include the need to address the role of pain and menthol cigarette use in the assessment and treatment of nicotine dependence, particularly among Black adults. These data may help to inform evolving tobacco control policies aimed at regulating or banning menthol tobacco additives.

Longitudinal Associations Between Pain and Use of Cigarettes and E-cigarettes in the Population Assessment of Tobacco and Health (PATH) Study.

INTRODUCTION: Pain has been implicated in the onset and maintenance of nicotine addiction, and there is initial cross-sectional evidence of covariation between pain and the use of cigarettes and e-cigarettes. The goals of the current study were to: (1)test pain severity as a predictor of initiating co-use of cigarettes and e-cigarettes, (2)examine longitudinal associations between pain and use/co-use of cigarettes and e-cigarettes, (3)generate the first prevalence rate data regarding cigarette and e-cigarette use as a function of pain, and (4)examine gender as a moderator of these associations. AIMS AND METHODS: Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (2013-2018). RESULTS: Among exclusive cigarette smokers at Wave 1 (n = 7719), pain severity was associated with a greater likelihood of and faster trajectory to initiating co-use of cigarettes and e-cigarettes (ps < .05). A significant pain × gender interaction (p < .05) revealed this prospective relationship was stronger among women. Among adult respondents who provided at least three waves of data (n = 24 255), greater Wave 1 pain severity was positively associated with e-cigarette use, cigarette smoking, and co-use of cigarettes and e-cigarettes at Waves 2, 3, and 4 (ps < .001). At Wave 4 (n = 33 822), adults with moderate or severe pain endorsed rates of e-cigarette and cigarette use almost two times greater versus no or low pain (ps < .001). CONCLUSIONS: Collectively, these findings provide evidence that pain likely serves as an important candidate risk factor for the initiation and maintenance of cigarette and e-cigarette use. IMPLICATIONS: This is the first prospective study to show that pain serves as an important risk factor for initiation and maintenance of cigarette and e-cigarette use over time. Weighted prevalence estimates further demonstrated that individuals with moderate or severe pain endorsed rates of cigarette and e-cigarette use and co-use approximately two times greater compared to those with no or low pain. These findings highlight a subpopulation of nicotine users more susceptible to greater healthcare burden, nicotine dependence, and physical impairment. Nicotine users with comorbid pain may benefit from integrated interventions that address pain in the context of cessation.

Perceived Pain and Smoking Interrelations Among Veterans with Chronic Pain Enrolled in a Smoking Cessation Trial.

INTRODUCTION: The Pain and Smoking Inventory (PSI) measures patients' perceived interrelations of their pain and smoking behavior, and it comprises three conceptually distinct domains: smoking to cope with pain (PSI-Cope), pain as a motivator of smoking (PSI-Motivate), and pain as a barrier to cessation (PSI-Barrier). Associations between PSI scores and pain interference and self-efficacy to quit smoking, two measures that can affect cessation outcomes, remain unclear. METHODS: We conducted a secondary analysis of baseline data from 371 veterans with chronic pain (88% male, Medianage =60) enrolled in a randomized smoking cessation trial. We used sequential multivariate regression models to examine associations between the three PSI domains and pain interference / self-efficacy. RESULTS: Of 371 veterans who completed baseline surveys, 88% were male, with a median age of 60 years. PSI-Motivate scores were positively associated with pain interference (beta [B]: 0.18, 95% confidence interval [CI]: 0.02 to 0.34). PSI-Barrier subscores were negatively associated with self-efficacy (B: -0.23, 95% CI: -0.36 to -0.10). CONCLUSION: Findings suggest that individuals who hold maladaptive perceptions of pain-smoking interrelations could be more likely to endorse higher pain interference and lower self-efficacy-two established predictors of cessation outcomes. Moreover, each PSI subscale demonstrated unique relationships with the dependent variables, and our results provided support for a three-factor structure. These findings further demonstrate that the PSI comprises three conceptually and empirically distinct domains; future research should evaluate the clinical utility of assessing each domain in relation to cessation outcomes.

Pain Intensity, Emotion Dysregulation, and Hazardous Drinking Among Adults With Chronic Pain.

OBJECTIVE: Chronic pain and hazardous alcohol use (i.e., a pattern of alcohol consumption that increases risk for harmful consequences) are prevalent and frequently comorbid conditions that have been posited to interact in a bidirectional manner, leading to greater pain and heavier drinking. Despite evidence that emotion dysregulation (i.e., difficulty modulating emotional responses when experiencing negative emotions) is independently associated with both greater pain and greater alcohol consumption, we are not aware of any previous research examining relations between emotion dysregulation, pain intensity, and hazardous alcohol use among individuals with chronic pain. METHOD: Participants included 125 past-month alcohol users with chronic musculoskeletal pain (38.4% female; mean age = 32.97 years; mean drinks/day = 1.62) who were recruited for an online survey study of pain and substance use. RESULTS: As expected, emotion dysregulation was positively associated with increased odds of hazardous alcohol use. We also observed a significant indirect association, such that higher levels of emotion dysregulation were associated with greater pain intensity, which in turn was associated with a greater likelihood of scoring above the Alcohol Use Disorders Identification Test cutoff for hazardous alcohol use. CONCLUSIONS: These findings suggest that emotion dysregulation may contribute to hazardous drinking among individuals with chronic pain, perhaps indirectly via pain amplification. Emotion dysregulation warrants consideration as a potential transdiagnostic vulnerability factor in comorbid chronic pain and hazardous drinking. Future prospective research is needed to examine causal pathways and establish temporal precedence.

The Role of Experiential Avoidance in Terms of Fatigue and Pain During COVID-19 Among Latinx Adults.

Background: Latinx persons are overrepresented in terms of 2019 Coronavirus (COVID-19) infection rates and constitute a subpopulation at increased risk for COVID-19 related physical ailments. Fatigue and pain are among the most prevalent somatic symptoms among the Latinx population; however, there is little understanding of individual difference factors that are related to fatigue and pain during COVID-19 among this health disparities population. Experiential avoidance (EA) reflects the persistent tendency to avoid aversive internal sensations. Methods: The current study sought to extend past work by exploring EA in relation to fatigue severity, pain intensity, and pain disability among 182 Latinx adult persons during the COVID-19 pandemic. Results: Results indicated that EA accounted for a statistically significant amount of variance across the criterion variables. Conclusions: Overall, the current work provides initial empirical evidence that EA is related to greater fatigue severity and pain severity/disability among Latinx persons during COVID-19.