title: Association between physical pain and alcohol treatment outcomes: The mediating role of negative affect.
abstract: OBJECTIVE
  Physical pain and negative affect have been described as risk factors for alcohol use following alcohol treatment. The current study was a secondary analysis of 2 clinical trials for alcohol use disorder (AUD) to examine the associations between pain, negative affect and AUD treatment outcomes.
  
  
  METHODS
  Participants included 1,383 individuals from the COMBINE Study (COMBINE Pharmacotherapies and Behavioral Interventions for Alcohol Dependence; COMBINE Study Research Group, 2003; 31% female, 23% ethnic minorities, average age = 44.4 [SD = 10.2]), a multisite combination pharmacotherapy and behavioral intervention study for AUD in the United States, and 742 individuals from the United Kingdom Alcohol Treatment Trial (UKATT Research Team, 2001; 25.9% female, 4.4% ethnic minorities, average age = 41.6 [SD = 10.1]) a multisite behavioral intervention study for AUD in the United Kingdom. The Form-90 was used to collect alcohol use data, the Short Form Health Survey and Quality of Life measures were used to assess pain, and negative affect was assessed using the Brief Symptom Inventory (COMBINE) and the General Health Questionnaire (UKATT).
  
  
  RESULTS
  Pain scores were significantly associated with drinking outcomes in both datasets. Greater pain scores were associated with greater negative affect and increases in pain were associated with increases in negative affect. Negative affect significantly mediated the association between pain and drinking outcomes and this effect was moderated by social behavior network therapy (SBNT) in the UKATT study, with SBNT attenuating the association between pain and drinking.
  
  
  CONCLUSIONS
  Findings suggest pain and negative affect are associated among individuals in AUD treatment and that negative affect mediated pain may be a risk factor for alcohol relapse.
authors.affiliation: Department of Psychology, University of New Mexico.
authors.forename: Katie
authors.initials: K
authors.lastname: Witkiewitz
authors.affiliation: Department of Psychology, University of New Mexico.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McCallion
authors.affiliation: Department of Psychology, University of New Mexico.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Vowles
authors.affiliation: Department of Psychology, University of New Mexico.
authors.forename: Megan
authors.initials: M
authors.lastname: Kirouac
authors.affiliation: Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico.
authors.forename: Tessa
authors.initials: T
authors.lastname: Frohe
authors.affiliation: Department of Psychology, Syracuse University.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Maisto
authors.affiliation: Alcohol Research UK.
authors.forename: Ray
authors.initials: R
authors.lastname: Hodgson
authors.affiliation: Department of Psychology, Northumbria University.
authors.forename: Nick
authors.initials: N
authors.lastname: Heather
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D019973:Alcohol-Related Disorders / Q000188:drug therapy / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000503:physiopathology*; D011788:Quality of Life; D012008:Recurrence; D012307:Risk Factors; D006113:United Kingdom; D014481:United States