Date of Award

Summer 7-16-2021

Degree Type


Degree Name

Doctor of Philosophy (PhD)




Maisto, Stephen A.


acceptance training, alcohol, experimental, physical pain

Subject Categories

Clinical Psychology | Psychology | Social and Behavioral Sciences


Excessive alcohol use is a leading cause of preventable death and disproportionately affects people with pain. Experimental research has identified pain as a determinant of alcohol use proxies that has its influence via negative affect (i.e. mediation effect). Although experimental research has shown that acceptance coping reduces pain-related negative affect, such effects have not been examined within the context of the pain and alcohol relationship. The purpose of this study was to test acceptance coping (vs. distraction) as a moderator of the previously established mediation model. Based on a randomized 2x2 between-subjects repeated-measures experimental design, pain-free hazardous drinkers (N = 135) were randomly assigned to receive acceptance or distraction coping training. They were asked to use the strategy while receiving a painful or non-painful acute stimulus. It was hypothesized that the effects of pain condition on negative affect would be weaker among those who received acceptance training, which would, in turn, result in lower ratings on alcohol use proxy measures vs. those receiving distraction. The indirect effects of coping condition were non-significant and there were no pain condition X coping condition effects on negative affect. Given this, the moderator was removed, and a simple mediation model was tested. Results showed significant indirect effects for alcohol urge through negative affect. Pain condition predicted increases in negative affect, but negative affect did not effect alcohol use proxies. Results suggest that there are no differences between acceptance and distraction coping in ameliorating the effects of acute pain on negative affect and alcohol use proxies. The previous mediation model was partially replicated. Findings provide information that may accelerate the design of interventions to curtail drinking for pain-coping by better understanding the utility of acceptance training and the pain and alcohol relation.


Open Access