{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T17:15:32Z","timestamp":1778174132978,"version":"3.51.4"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"NIDA","doi-asserted-by":"publisher","award":["R01 DA032776-05"],"award-info":[{"award-number":["R01 DA032776-05"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Individuals with chronic non-cancer pain (CNCP) often present with significant challenges that can impact physical, psychological, and social well-being. Mental defeat is a critical consequence of CNCP being a known predictor of suicidality. This study examines the relationships between specific psychological and coping factors and mental defeat among individuals with CNCP on long-term opioid therapy (LTOT).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A cross-sectional study of secondary data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Primary care, pain, and substance abuse clinics in Pennsylvania, Washington, and Utah.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Subjects<\/jats:title>\n                  <jats:p>744 adults with CNCP receiving LTOT (\u2265 6\u2009months).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Anxiety and depression symptoms and pain coping strategies were examined with hierarchical multiple linear regression analysis to describe their relationship to mental defeat. In an exploratory analysis, we also stratified the sample by the presence of opioid use disorder (OUD) to determine if the associations were differently represented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After controlling for covariates, anxiety (\u03b2\u2009=\u20097.07, P\u2009&amp;lt;\u2009.001) and depression symptoms (\u03b2\u2009=\u200914.17, P\u2009&amp;lt;\u2009.001) were statistically significant correlates of increased mental defeat. Diverting attention (\u03b2\u2009=\u20090.31, P\u2009&amp;lt;\u2009.05), coping self-statements (\u03b2\u2009= -0.30, P\u2009&amp;lt;\u2009.05), and catastrophizing (\u03b2\u2009=\u20091.47, P\u2009&amp;lt;\u2009.001) were significant correlates, explaining 51% of the variance in mental defeat (P\u2009&amp;lt;\u2009.001). Exploratory analysis revealed subgroup differences, such that while depression symptoms and catastrophizing were significant correlates of mental defeat in persons with and without OUD, anxiety and diverting attention were significant only in persons without OUD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings identify key psychological and coping correlates of mental defeat in persons with CNCP on LTOT, informing the development of interventions to mitigate it, and thereby reducing the risk of suicide in this vulnerable population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pm\/pnaf055","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T19:08:32Z","timestamp":1746731312000},"page":"576-582","source":"Crossref","is-referenced-by-count":1,"title":["Correlates of mental defeat in individuals with chronic non-cancer pain on long-term opioid therapy"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7115-4192","authenticated-orcid":false,"given":"Yoonjae","family":"Lee","sequence":"first","affiliation":[{"name":"School of Nursing, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas A","family":"Giordano","sequence":"additional","affiliation":[{"name":"Nell Hodgson Woodruff School of Nursing, Emory University , Atlanta, GA 30322,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peggy A","family":"Compton","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]},{"name":"Leonard Davis Institute of Health Economics, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7836-9965","authenticated-orcid":false,"given":"Nicole K Y","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Warwick , Coventry CV4 7AL,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary C","family":"Polomano","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]},{"name":"Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6793-6474","authenticated-orcid":false,"given":"Martin D","family":"Cheatle","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]},{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA 19104,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"issue":"15","key":"2025090303523572600_pnaf055-B1","doi-asserted-by":"publisher","first-page":"379","DOI":"10.15585\/mmwr.mm7215a1","article-title":"Chronic pain among adults\u2014United States, 2019-2021","volume":"72","author":"Rikard","year":"2023","journal-title":"MMWR Morb Mort Weekly Rep"},{"issue":"3","key":"2025090303523572600_pnaf055-B2","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.jpain.2014.01.004","article-title":"The ACTTION-American Pain Society Pain 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