{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T04:45:27Z","timestamp":1782535527336,"version":"3.54.5"},"reference-count":66,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007126","name":"Syracuse University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol, Clinical and Experimental Research"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic pain and hazardous alcohol use are prevalent and commonly co\u2010occur among US veterans. A growing literature highlights pain as a motivator of alcohol consumption, with evidence suggesting more intense pain is associated with an increased likelihood of drinking for pain management. Although chronic pain acceptance (i.e., willingness to experience chronic pain and its sequelae while maintaining engagement in valued life activities) has emerged as a protective factor in the context of opioid\u2010related behavior, its role in shaping pain\u2010alcohol relations has not been examined. The goal of this cross\u2010sectional study was to test chronic pain acceptance as a moderator of the association between pain intensity and alcohol use severity among veterans with chronic musculoskeletal pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Veterans (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009429;\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200956.6) were recruited via Qualtrics Panels for an online survey. Measures included the Graded Chronic Pain Scale, Chronic Pain Acceptance Questionnaire, and Alcohol Use Disorders Identification Test. Hierarchical linear regression and conditional effects models were used to test associations between pain intensity, chronic pain acceptance, and alcohol use severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Chronic pain acceptance moderated the relationship between pain intensity and alcohol use severity, with a positive association observed at low but not moderate or high levels of acceptance. Exploratory subgroup analyses among veterans scoring above threshold for hazardous drinking also revealed an interaction, though none of the conditional effects were statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current findings suggest that higher levels of chronic pain acceptance may buffer the impact of pain on alcohol use. Additional research is needed to evaluate the utility of acceptance\u2010based interventions for veterans with co\u2010occurring chronic pain and hazardous drinking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70305","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:01:32Z","timestamp":1781276492000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Pain Acceptance Moderates the Association Between Pain Intensity and Alcohol Use Severity Among Veterans With Chronic Musculoskeletal Pain"],"prefix":"10.1111","volume":"50","author":[{"given":"Kyle M.","family":"White","sequence":"first","affiliation":[{"name":"Center for Health Behavior Research &amp; Innovation, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"},{"name":"Department of Psychology, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5119-1939","authenticated-orcid":false,"given":"Victoria E.","family":"Carlin","sequence":"additional","affiliation":[{"name":"Center for Health Behavior Research &amp; Innovation, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"},{"name":"Department of Psychology, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Kyung","family":"Nam","sequence":"additional","affiliation":[{"name":"Center for Health Behavior Research &amp; Innovation, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"},{"name":"Department of Psychology, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph W.","family":"Ditre","sequence":"additional","affiliation":[{"name":"Center for Health Behavior Research &amp; Innovation, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"},{"name":"Department of Psychology, College of Arts &amp; Sciences Syracuse University  Syracuse New York USA"},{"name":"D'Aniello Institute for Veterans &amp; Military Affairs Syracuse University  Syracuse New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2018.05.009"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01074.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000506"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v38.1.02"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000792"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050718-095440"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000975"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2012.07.010"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12263"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9499-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S144631"},{"key":"e_1_2_9_15_1","volume-title":"Discovering Statistics Using IBM SPSS Statistics","author":"Field A.","year":"2024"},{"key":"e_1_2_9_16_1","first-page":"13","article-title":"Complementary and Integrative Health Therapies for Opioid Overuse: An Opportunity for the VA","volume":"35","author":"Fletcher C. E.","year":"2018","journal-title":"Federal Practitioner"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.60.710.865"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.07.003"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.51.1.115"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13423"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.07.009"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.03.034"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy235"},{"key":"e_1_2_9_24_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression\u2010Based Approach","author":"Hayes A. F.","year":"2013"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(04)80013-3"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2005.06.006"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.64.6.1152"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12388"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.2196\/resprot.8071"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr089"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2010.03.023"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny197"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcbs.2022.10.004"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.3109\/10673229709030550"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000342"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.10.017"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10880-025-10072-6"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00406-1"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2006.02.006"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1037\/12067-001"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-006-0018-y"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2003.10.012"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2019.03.023"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2010.07.010"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1037\/pha0000170"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2023.109833"},{"key":"e_1_2_9_47_1","volume-title":"Use of VA Benefits and Services: 2023 (No. 1)","author":"National Center for Veterans Analysis and Statistics","year":"2025"},{"key":"e_1_2_9_48_1","volume-title":"Summary Health Statistics: National Health Interview Survey","author":"National Health Interview Survey","year":"2018"},{"key":"e_1_2_9_49_1","article-title":"The Power of Outliers (and Why Researchers Should Always Check for Them)","volume":"9","author":"Osborne J.","year":"2004","journal-title":"Practical Assessment, Research & Evaluation"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.7326\/M21-4011"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.812247"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2009.08.003"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2009.03.005"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1993.tb02093.x"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2022.107495"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-010-0170-2"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.11.009"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1177\/00332941221080413"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001384"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(92)90154-4"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2022.06.003"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2019.0275"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10880-024-10061-1"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13594"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.02.005"},{"key":"e_1_2_9_66_1","article-title":"Cognitive\u2010Affective Transdiagnostic Factors Associated With Vulnerability to Alcohol and Prescription Opioid Use in the Context of Pain","volume":"41","author":"Zale E. L.","year":"2021","journal-title":"Alcoholism: Clinical and Experimental Research"},{"key":"e_1_2_9_67_1","unstructured":"Zelaya C. E. J. M.Dahlhamer J. W.Lucas andE. M.Connor.2020.\u201cChronic Pain and High\u2010Impact Chronic Pain Among U.S. Adults 2019.\u201dNCHS Data Brief; No 390 NCHS Data Briefs."}],"container-title":["Alcohol, Clinical and Experimental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70305","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acer.70305","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acer.70305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T03:47:28Z","timestamp":1782532048000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acer.70305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":66,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/acer.70305"],"URL":"https:\/\/doi.org\/10.1111\/acer.70305","archive":["Portico"],"relation":{},"ISSN":["2993-7175","2993-7175"],"issn-type":[{"value":"2993-7175","type":"print"},{"value":"2993-7175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70305"}}