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Pain is a complex construct contributing to significant impairment, particularly among physically injured patients seeking treatment in trauma and orthopedic surgery settings in which social workers are an integral component of care. The biopsychosocial theory, fear-avoidance, and cognitive mediation models of pain suggest that psychological factors (for example, depression) affect one's ability to tolerate distress, leading to negative pain appraisals, such as catastrophizing. This study examined whether distress tolerance serves as a mechanism by which depression is associated with pain catastrophizing. We administered a health survey to outpatient trauma and orthopedic surgery clinic patients who were using opioid medications; 84 patients were included in the final analysis; 39.3 percent screened positive for depression. A multilevel mediation model using structural equation modeling revealed a significant direct effect from depression to pain catastrophizing (ß = .31, z = 3.96, p < .001) and a significant indirect effect by distress tolerance (Δß = .27, z = 3.84, p < .001). These results, which suggest that distress tolerance partially mediated the path from depression to pain catastrophizing, can inform social workers and other members of the multidisciplinary team about both the critical role of psychosocial factors after injury and interventions to improve postinjury recovery., (© 2021 National Association of Social Workers.)

In a sample of adults who reported cutting down on their alcohol use in the past 3 months, study goals were to Identify how many increased consumption of licit substances (called 'substituters'); and analyze the psychological profiles of substituters compared to non-substituters. Participants (25.6% Latinx, 46.2% female) were recruited using Amazon's Mturk and completed questionnaires on substance use substitution (i.e. any increased use of a substance while cutting down on another substance) and stress, depression, and anxiety. Among those reporting decreases in alcohol use (N = 78), 78% substituted (N = 61), defined as concomitant increases in food, cannabis, or nicotine. Substituters had higher levels of pysychological distress, reported greater polysubstance use and significantly higher levels of problems related to use than non-substituters. All of the Latinx participants (n = 20) reported substitution and reported significantly higher psychological distress than non-Latinx substituters. Latinxs who reported substitution had more serious psychological profiles and problems related to substance use. The findings provide evidence for a clinical phenomenon involving substitution in a non-treatment sample. Future studies should examine this phenomenon among people in addiction treatment and among Latinxs. [ABSTRACT FROM AUTHOR]