{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:42:51Z","timestamp":1788579771504,"version":"build-2803163510"},"reference-count":69,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011349","name":"University of Texas at El Paso","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Substance use disorders (SUDs) are a critical issue among veterans, often co-occurring with mental illnesses and negatively impacting their well-being. This study explores the mediating role of well-being, as conceptualized by the PERMA model, in the relationship between ability to engage in social roles and activities and degree of problems related to drug abuse among veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 156 veterans with self-reported mental health conditions. A parallel multiple mediation analysis using PROCESS macro assessed the role of PERMA components in mediating the relationship between ability to engage in social roles and activities and degree of problems related to drug abuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ability to engage in social roles and activities was positively correlated with overall well-being (r = .49, p &amp;lt;.05) and negatively correlated with degree of problems related to drug abuse (r = \u2212.19, p &amp;lt;.05). Mediation analysis revealed that PERMA fully mediated the relationship between ability to engage in social roles and activities and degree of problems related to drug abuse, with accomplishment emerging as a significant indirect pathway (Effect = \u22120.05). The model explained 17% of the variance in degree of problems related to drug abuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings underscore the importance of well-being, particularly accomplishment, in the relationship between veterans\u2019 ability to engage in social roles and activities and degree of problems related to drug abuse. Interventions integrating well-being frameworks may offer holistic approaches to recovery for veterans with SUDs and mental illnesses. Future research should explore longitudinal effects of PERMA-focused interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1571625","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:37:24Z","timestamp":1758087444000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The mediating role of PERMA in the relationship between social role engagement and drug use problems among veterans with mental illness"],"prefix":"10.3389","volume":"16","author":[{"given":"Rebecca","family":"Campa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermina R.","family":"Solis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muharrem","family":"Koc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa A.","family":"Granger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Umucu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","DOI":"10.1177\/00343552221077942","article-title":"Reducing the influence of perceived stress on subjective well-being of student veterans with and without disabilities: The protective role of positive traits and social support","volume":"67","author":"Umucu","year":"2023","journal-title":"Rehabilitation Counseling Bulletin"},{"key":"B2","doi-asserted-by":"crossref","DOI":"10.1007\/s11136-020-02642-y","article-title":"Pain intensity and mental health quality of life in veterans with mental illnesses: the intermediary role of physical health and the ability to participate in activities","volume":"30","author":"Umucu","year":"2021","journal-title":"Qual Life Res"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.1097\/NMD.0000000000001406","article-title":"Is gratitude associated with suicidal ideation in veterans with mental illness and student veterans with PTSD symptoms","volume":"210","author":"Umucu","year":"2022","journal-title":"J Nerv Ment Dis"},{"key":"B4","doi-asserted-by":"crossref","DOI":"10.1177\/0034355220957093","article-title":"Examining the structure of the PERMA theory of well-being in veterans with mental illnesses","volume":"64","author":"Umucu","year":"2021","journal-title":"Rehabil Couns Bull"},{"key":"B5","volume-title":"Mental illness","year":"2024"},{"key":"B6","volume-title":"Veteran and military mental health issues","author":"Inoue","year":"2023"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/s0033291720001944","article-title":"Mental health disorders and alcohol misuse among UK military veterans and the general population: a comparison study","volume":"52","author":"Rhead","year":"2020","journal-title":"psychol Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.drugalcdep.2018.12.030","article-title":"Co-occurring substance use and mental disorders among adults with opioid use disorder","volume":"197","author":"Jones","year":"2019","journal-title":"Drug Alcohol Depend"},{"key":"B9","unstructured":"Mental health and substance use co-occurring disorders\n          \n          \n          \n          2023"},{"key":"B10","volume-title":"Substance use and military life drugfacts","year":"2019"},{"key":"B11","unstructured":"2018 national survey on drug use and health: veterans\n          \n          \n            \n              McCance-Katz\n              E\n            \n          \n          \n          2019"},{"key":"B12","volume-title":"Statistics on veterans and substance abuse","author":"Miller","year":"2021"},{"key":"B13","doi-asserted-by":"crossref","DOI":"10.1080\/07853890.2022.2092896","article-title":"US Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts","volume":"54","author":"Bennett","year":"2022","journal-title":"Annals of medicine"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.5539\/gjhs.v5n6p40","article-title":"A comparative study of self-regulation in substance dependent and non-dependent individuals","volume":"5","author":"Bakhshani","year":"2013","journal-title":"Global J Health Sci"},{"key":"B15","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1037\/0033-2909.117.3.497","article-title":"The need to belong: desire for interpersonal attachments as a fundamental human motivation","volume":"117","author":"Baumeister","year":"1995","journal-title":"psychol Bull"},{"key":"B16","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.cpr.2006.04.002","article-title":"The clinical significance of loneliness: A literature review","volume":"26","author":"Heinrich","year":"2006","journal-title":"Clin Psychol Rev"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.5812\/ijhrba.22688","article-title":"Emotional and social loneliness in individuals with and without substance dependence disorder","volume":"3","author":"Hosseinbor","year":"2014","journal-title":"Int J High Risk Behav Addict"},{"key":"B18","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugalcdep.2024.111268","article-title":"A randomized clinical trial to assess feasibility, acceptability and preliminary effects of telehealth-delivered cognitive-behavioral therapy for perceived social isolation among individuals with opioid use disorders","volume":"258","author":"Ashrafioun","year":"2024","journal-title":"Drug and Alcohol Dependence"},{"key":"B19","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1037\/a0034669","article-title":"The effects of social contact on drug use: Behavioral mechanisms controlling drug intake","volume":"22","author":"Strickland","year":"2014","journal-title":"Exp Clin Psychopharmacol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2021.2022625","article-title":"Social isolation and well-being in veterans with mental illness","volume":"32","author":"Grenawalt","year":"2023","journal-title":"J Ment Health"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/smi.3339","article-title":"Employment and emotional well-being in veterans with mental illness","volume":"40","author":"Umucu","year":"2024","journal-title":"Stress Health"},{"key":"B22","doi-asserted-by":"crossref","DOI":"10.1023\/A:1001930101541","article-title":"An ethnographic study of the longitudinal course of substance abuse among people with severe mental illness","volume":"36","author":"Alverson","year":"2000","journal-title":"Community Mental Health Journal"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/encyclopedia3030082","article-title":"Integrating positive psychology into substance use treatments","volume":"3","author":"Stone","year":"2023","journal-title":"Encyclopedia"},{"key":"B24","volume-title":"Flourish: A visionary new understanding of happiness and well-being","author":"Seligman","year":"2011"},{"key":"B25","doi-asserted-by":"crossref","DOI":"10.1002\/bdm.1753","article-title":"Data collection in a flat world: The strengths and weaknesses of Mechanical Turk samples","volume":"26","author":"Goodman","year":"2013","journal-title":"Journal of Behavioral Decision Making"},{"key":"B26","doi-asserted-by":"crossref","DOI":"10.4135\/9781526437280","article-title":"Using Amazon Mechanical Turk to recruit participants with disabilities","author":"Lund","year":"2018"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtbi.2011.03.004","article-title":"The promise of Mechanical Turk: How online labor markets can help theorists run behavioral experiments","volume":"299","author":"Rand","year":"2012","journal-title":"Journal of Theoretical Biology"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000250","article-title":"Microaggressions and social support among sexual minorities with physical disabilities","volume":"64","author":"Conover","year":"2019","journal-title":"Rehabilitation Psychology"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000166","article-title":"Disability pride protects self-esteem through the rejection-identification model","volume":"63","author":"Bogart","year":"2018","journal-title":"Rehabilitation Psychology"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/smi.70004","article-title":"Reasons to worry about employment during COVID-19 among veterans with disabilities","volume":"41","author":"Umucu","year":"2025","journal-title":"Stress Health."},{"key":"B31","doi-asserted-by":"crossref","DOI":"10.1177\/0034355220967093","article-title":"The protective role of character strengths in COVID-19 stress and well-being in individuals with chronic conditions and disabilities: An exploratory study","volume":"64","author":"Umucu","year":"2021","journal-title":"Rehabil Couns Bull"},{"key":"B32","doi-asserted-by":"crossref","DOI":"10.1080\/07448481.2022.2071619","article-title":"Measuring COVID-19 vaccine hesitancy among college students with disabilities: Sociodemographic and psychological correlates of COVID-19 vaccine hesitancy","volume":"72","author":"Umucu","year":"2024","journal-title":"J Am Coll Health"},{"key":"B33","doi-asserted-by":"crossref","DOI":"10.1002\/smi.3099","article-title":"Associations between mental health and job loss among middle- and low-income veterans and civilians during the COVID-19 pandemic: An exploratory study","volume":"38","author":"Umucu","year":"2022","journal-title":"Stress Health"},{"key":"B34","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1037\/prj0000420","article-title":"Measuring grit in veterans with mental illnesses: Examining the model structure of grit","volume":"44","author":"Umucu","year":"2021","journal-title":"Psychiatr Rehabil J"},{"key":"B35","article-title":"Development and validation of a scale of negative attitudes toward COVID-19 with a sample of people with chronic conditions and disabilities","volume":"52","author":"Umucu","year":"2021","journal-title":"J Appl Rehabil Couns"},{"key":"B36","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1037\/rep0000448","article-title":"Relations among gratitude, adaptation to disability, and flourishing among adults with disabilities: A longitudinal mediation model","volume":"67","author":"Phillips","year":"2022","journal-title":"Rehabil Psychol"},{"key":"B37","doi-asserted-by":"crossref","DOI":"10.3233\/JVR-221211","article-title":"COVID-19 stress, resilience, and job loss concerns in people with chronic conditions and disabilities","volume":"57","author":"Thimbriel","year":"2022","journal-title":"J Vocat Rehabil"},{"key":"B38","article-title":"The intermediary role of loneliness in the relationship between COVID-19 stress and maladaptive coping among people with disabilities and chronic health conditions","volume":"87","author":"Lee","year":"2021","journal-title":"J Rehabil"},{"key":"B39","doi-asserted-by":"crossref","DOI":"10.1097\/JOM.0000000000002734","article-title":"Job automation and concerns during the COVID-19 pandemic among middle- and low-income US adults","volume":"65","author":"Tsai","year":"2023","journal-title":"J Occup Environ Med"},{"key":"B40","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinepi.2015.08.034","article-title":"The PROMIS satisfaction with social participation measures demonstrated responsiveness in diverse clinical populations","volume":"73","author":"Hahn","year":"2016","journal-title":"Journal of Clinical Epidemiology"},{"key":"B41","doi-asserted-by":"crossref","DOI":"10.5502\/ijw.v6i3.526","article-title":"The PERMA-Profiler: A brief multidimensional measure of flourishing","volume":"6","author":"Butler","year":"2016","journal-title":"International Journal of Wellbeing"},{"key":"B42","doi-asserted-by":"crossref","DOI":"10.1016\/0306-4603(82)90005-3","article-title":"The Drug Abuse Screening Test","volume":"7","author":"Skinner","year":"1982","journal-title":"Addictive Behavior"},{"key":"B43","volume-title":"Introduction to mediation, moderation, and conditional process analysis: A regression-based approach","author":"Hayes","year":"2017"},{"key":"B44","article-title":"Advanced statistics: bootstrapping confidence intervals for statistics with \u201cdifficult\u201d distributions","volume":"12","author":"Haukoos","year":"2005","journal-title":"Academic Emergency Medicine"},{"key":"B45","article-title":"Power of mediation effects using bootstrap resampling","author":"Steffener","year":"2021","journal-title":"arXiv preprint"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000059","article-title":"Liking, wanting, and the incentive-sensitization theory of addiction","volume":"71","author":"Berridge","year":"2016","journal-title":"Am Psychol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1007\/s40614-019-00203-4","article-title":"The utility of operant conditioning to address poverty and drug addiction","volume":"42","author":"Silverman","year":"2019","journal-title":"Perspect Behav Sci"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.12.026","article-title":"Subjective effects to marijuana associated with marijuana use in community and clinical subjects","volume":"109","author":"Zeiger","year":"2010","journal-title":"Drug Alcohol Depend"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/iby050","article-title":"Team Red, White & Blue: A community-based model for harnessing positive social networks to enhance enrichment outcomes in military veterans reintegrating to civilian life","volume":"8","author":"Angel","year":"2018","journal-title":"Trans Behav Med"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1037\/0735-7028.39.4.451","article-title":"Welcoming them home: Supporting service members and their families in navigating the tasks of reintegration","volume":"39","author":"Bowling","year":"2008","journal-title":"Prof Psychol.: Res Pract"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1177\/0146167213499186","article-title":"To belong is to matter: Sense of belonging enhances meaning in life","volume":"39","author":"Lambert","year":"2013","journal-title":"Pers Soc Psychol Bull"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1177\/00343552221146162","article-title":"Drug use difficulties and academic adjustment in student veterans with disabilities: A parallel mediation study","volume":"67","author":"Rumrill","year":"2023","journal-title":"Rehabil Couns Bull"},{"key":"B53","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1177\/00343552221127032","article-title":"Evaluating optimism, hope, resilience, coping flexibility, secure attachment, and PERMA as a well-being model for college life adjustment of student veterans: A hierarchical regression analysis","volume":"67","author":"Umucu","year":"2022","journal-title":"Rehabil Couns Bull"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfda.2013.09.038","article-title":"Family and social aspects of substance use disorders and treatment","volume":"21","author":"Daley","year":"2013","journal-title":"J Food Drug Anal"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0281575","article-title":"Exploring the trajectory and correlates of social isolation for veterans across a 6-month period during COVID-19","volume":"18","author":"McGuire","year":"2023","journal-title":"PloS One"},{"key":"B56","doi-asserted-by":"crossref","DOI":"10.1177\/00343552221127032","article-title":"Evaluating optimism, hope, resilience, coping flexibility, secure attachment, and PERMA as a well-being model for college life adjustment of student veterans: A hierarchical regression analysis","volume":"67","author":"Umucu","year":"2024","journal-title":"Rehabilitation Counseling Bulletin,"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1080\/03071847.2014.969946","article-title":"Service life and beyond\u2013institution or culture","volume":"159","author":"Bergman","year":"2014","journal-title":"RUSI J"},{"key":"B58","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/0022167816687674","article-title":"Meaning in life and substance use","volume":"60","author":"Csabonyi","year":"2020","journal-title":"J Humanistic Psychol"},{"key":"B59","doi-asserted-by":"publisher","first-page":"31","DOI":"10.3109\/10826080902858334","article-title":"Adderall is definitely not a drug\u201d: justifications for the illegal use of ADHD stimulants","volume":"45","author":"DeSantis","year":"2010","journal-title":"Subst Use Misuse"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.52017\/001c.55516","article-title":"Employment and rehabilitation for veterans with chronic conditions and disabilities: Strengths, challenges, opportunities, and policy suggestions","volume":"12","author":"Umucu","year":"2023","journal-title":"Rehabil Counselors Educators J"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1002\/smi.3099","article-title":"Associations between mental health and job loss among middle-and low-income veterans and civilians during the COVID-19 pandemic: An exploratory study","volume":"38","author":"Umucu","year":"2022","journal-title":"Stress Health"},{"key":"B62","doi-asserted-by":"crossref","DOI":"10.1002\/smi.70004","article-title":"Reasons to worry about employment during COVID-19 among veterans with disabilities","volume":"41","author":"Umucu","year":"2025","journal-title":"Stress Health"},{"key":"B63","doi-asserted-by":"crossref","DOI":"10.3233\/JVR-201114","article-title":"Functional limitations and worrying to lose employment among individuals with chronic conditions and disabilities during COVID-19: A hierarchical logistic regression model","volume":"54","author":"Umucu","year":"2021","journal-title":"J Vocat Rehabil"},{"key":"B64","doi-asserted-by":"crossref","DOI":"10.1080\/17439760.2024.2427586","article-title":"Character strengths and employment in persons with disabilities: A national survey study","author":"Lee","year":"2024","journal-title":"J Posit Psychol"},{"key":"B65","doi-asserted-by":"crossref","DOI":"10.3233\/JVR-160814","article-title":"Self-efficacy as a mediator for the relationship between secure attachment style and employment status in individuals with spinal cord injuries","volume":"45","author":"Umucu","year":"2016","journal-title":"J Vocat Rehabil"},{"key":"B66","article-title":"Examining the associations between self-compassion, disability acceptance, and life satisfaction among individuals with spinal cord injury","volume":"64","author":"Umucu","year":"2019","journal-title":"Rehabil Psychol"},{"key":"B67","article-title":"Career adaptability and its relation to self-determination among individuals with intellectual disability","volume":"46","author":"Umucu","year":"2023","journal-title":"Career Dev Transit Except Individ"},{"key":"B68","unstructured":"Know the risks of using drugs\n          \n          \n          \n          2022"},{"key":"B69","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1177\/00343552221077942","article-title":"Reducing the influence of perceived stress on subjective well-being of student veterans with and without disabilities: the protective role of positive traits and social support","volume":"67","author":"Umucu","year":"2022","journal-title":"Rehabil Couns Bull"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1571625\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T05:37:32Z","timestamp":1758087452000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1571625\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,17]]},"references-count":69,"alternative-id":["10.3389\/fpsyt.2025.1571625"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1571625","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,17]]},"article-number":"1571625"}}