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Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility

BACKGROUND: Chronic pain and problematic substance use are commonly co-occurring and highly detrimental issues that are especially prevalent in U.S. veteran populations. Although COVID-19 made clinical management of these conditions potentially difficult, some research suggests that certain veterans...

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Autores principales: Reilly, Erin D., Wolkowicz, Noah R., Heapy, Alicia, Ross MacLean, R., Duarte, Brooke A., Chamberlin, Elizabeth S., Harris, J. Irene, Shirk, Steven D., Kelly, Megan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185850/
https://www.ncbi.nlm.nih.gov/pubmed/37205082
http://dx.doi.org/10.3389/fpsyg.2023.1173641
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author Reilly, Erin D.
Wolkowicz, Noah R.
Heapy, Alicia
Ross MacLean, R.
Duarte, Brooke A.
Chamberlin, Elizabeth S.
Harris, J. Irene
Shirk, Steven D.
Kelly, Megan M.
author_facet Reilly, Erin D.
Wolkowicz, Noah R.
Heapy, Alicia
Ross MacLean, R.
Duarte, Brooke A.
Chamberlin, Elizabeth S.
Harris, J. Irene
Shirk, Steven D.
Kelly, Megan M.
author_sort Reilly, Erin D.
collection PubMed
description BACKGROUND: Chronic pain and problematic substance use are commonly co-occurring and highly detrimental issues that are especially prevalent in U.S. veteran populations. Although COVID-19 made clinical management of these conditions potentially difficult, some research suggests that certain veterans with these conditions did not experience this period as negatively as others. It is thus important to consider whether resilience factors, such as the increasingly-studied process of psychological flexibility, might have led to better outcomes for veterans managing pain and problematic substance use during this time of global crisis. METHODS: This planned sub-analysis of a larger cross-sectional, anonymous, and nationally-distributed survey (N = 409) was collected during the first year of the COVID-19 pandemic. Veteran participants completed a short screener and battery of online surveys assessing pain severity and interference, substance use, psychological flexibility, mental health functioning, and pandemic-related quality of life. RESULTS: For veterans with chronic pain and problematic substance use, the pandemic resulted in a significant lowering of their quality of life related to meeting basic needs, emotional health, and physical health compared to veterans with problematic substance use but no chronic pain diagnosis. However, moderation analyses revealed that veterans with these comorbid conditions experienced less negative impacts from the pandemic on quality of life and mental health when they reported greater psychological flexibility. For veterans with problematic substance use only, psychological flexibility was also related to better mental health functioning, but did not significantly correlate with their quality of life. CONCLUSION: Results highlight how COVID-19 differentially impacted veterans with both problematic substance use and chronic pain, such that this group reported particularly negative impacts of the pandemic on multiple areas of quality of life. However, our findings further emphasize that psychological flexibility, a modifiable resiliency process, also buffered against some of the negative impacts of the pandemic on mental health and quality of life. Given this, future research into the impact of natural crises and healthcare management should investigate how psychological flexibility can be targeted to help increase resiliency for veterans with chronic pain and problematic substance use.
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spelling pubmed-101858502023-05-17 Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility Reilly, Erin D. Wolkowicz, Noah R. Heapy, Alicia Ross MacLean, R. Duarte, Brooke A. Chamberlin, Elizabeth S. Harris, J. Irene Shirk, Steven D. Kelly, Megan M. Front Psychol Psychology BACKGROUND: Chronic pain and problematic substance use are commonly co-occurring and highly detrimental issues that are especially prevalent in U.S. veteran populations. Although COVID-19 made clinical management of these conditions potentially difficult, some research suggests that certain veterans with these conditions did not experience this period as negatively as others. It is thus important to consider whether resilience factors, such as the increasingly-studied process of psychological flexibility, might have led to better outcomes for veterans managing pain and problematic substance use during this time of global crisis. METHODS: This planned sub-analysis of a larger cross-sectional, anonymous, and nationally-distributed survey (N = 409) was collected during the first year of the COVID-19 pandemic. Veteran participants completed a short screener and battery of online surveys assessing pain severity and interference, substance use, psychological flexibility, mental health functioning, and pandemic-related quality of life. RESULTS: For veterans with chronic pain and problematic substance use, the pandemic resulted in a significant lowering of their quality of life related to meeting basic needs, emotional health, and physical health compared to veterans with problematic substance use but no chronic pain diagnosis. However, moderation analyses revealed that veterans with these comorbid conditions experienced less negative impacts from the pandemic on quality of life and mental health when they reported greater psychological flexibility. For veterans with problematic substance use only, psychological flexibility was also related to better mental health functioning, but did not significantly correlate with their quality of life. CONCLUSION: Results highlight how COVID-19 differentially impacted veterans with both problematic substance use and chronic pain, such that this group reported particularly negative impacts of the pandemic on multiple areas of quality of life. However, our findings further emphasize that psychological flexibility, a modifiable resiliency process, also buffered against some of the negative impacts of the pandemic on mental health and quality of life. Given this, future research into the impact of natural crises and healthcare management should investigate how psychological flexibility can be targeted to help increase resiliency for veterans with chronic pain and problematic substance use. Frontiers Media S.A. 2023-05-02 /pmc/articles/PMC10185850/ /pubmed/37205082 http://dx.doi.org/10.3389/fpsyg.2023.1173641 Text en Copyright © 2023 Reilly, Wolkowicz, Heapy, Ross MacLean, Duarte, Chamberlin, Harris, Shirk and Kelly. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychology
Reilly, Erin D.
Wolkowicz, Noah R.
Heapy, Alicia
Ross MacLean, R.
Duarte, Brooke A.
Chamberlin, Elizabeth S.
Harris, J. Irene
Shirk, Steven D.
Kelly, Megan M.
Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
title Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
title_full Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
title_fullStr Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
title_full_unstemmed Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
title_short Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
title_sort chronic pain and problematic substance use for veterans during covid-19: the moderating role of psychological flexibility
topic Psychology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185850/
https://www.ncbi.nlm.nih.gov/pubmed/37205082
http://dx.doi.org/10.3389/fpsyg.2023.1173641
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