Term of Award

Summer 2023

Degree Name

Doctor of Psychology in Clinical Psychology (Psy.D.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Psychology

Committee Chair

Jessica Brooks

Committee Member 1

Jeff Klibert

Committee Member 2

Ryan Couillou


Pain-related disorders are the leading cause of disabilities globally (James et al., 2018). Some individuals with chronic pain report consuming alcohol to self-medicate which may be due to its analgesic properties (Thompson et al., 2017). The pain-reducing effects of alcohol are potentially reinforcing for individuals with chronic pain, and this relationship has the potential to create a difficult-to-break cycle (Egli et al., 2012). The purpose of the current study was to evaluate a proposed moderated mediation model explaining the pathways between pain and problematic alcohol use. Participants were recruited to complete an online survey through subreddits related to chronic pain. A cross-sectional design was used to investigate the relationships between pain severity, pain-related psychological flexibility, depressive symptoms, distress tolerance, and problematic alcohol use. The hypothesized moderated mediation model was not significant; however, some relationships in the model were. Contrary to what the originally hypothesized, pain severity had a negative direct effect on problematic alcohol use. In line with hypotheses, pain severity was positively associated with depressive symptoms, and this relationship was moderated by pain-related psychological flexibility. Distress tolerance moderated the relationship between depressive symptoms and problematic alcohol use; however, contrary to what was hypothesized, the relationship between depressive symptoms and alcohol use was insignificant when the moderator of distress tolerance was included in the model. Additionally, depressive symptoms did not mediate the relationship between pain severity and problematic alcohol use in the hypothesized moderated mediation model. Based on the results, it may be beneficial for psychological flexibility and distress tolerance to be targeted in psychotherapy for individuals with chronic pain and depressive symptoms.

OCLC Number


Research Data and Supplementary Material