Emotional risk factors for substance abuse in a chronic pain population: Developing a predictive model and testing methods for assessing stigmatized behaviors

EMOTIONAL RISK FACTORS FOR SUBSTANCE ABUSE IN A CHRONIC PAINPOPULATION: DEVELOPING A PREDICTIVE MODEL AND TESTING METHODSFOR ASSESSING STIGMATIZED BEHAVIORSbyLINDSAY MS OBERLEITNERAugust 2011 Advisor: Mark A. Lumley, Ph.D.Major: Psychology (Clinical)Degree: Doctor of PhilosophyThere are currently few factors guiding physicians’ decisions as to whether anindividual patient may need additional regulation of pain medications because of risks.The limited predictive factors applied to prescription opioid abuse in chronic painpatients is surprising given the breadth of personal, cognitive, and emotional factorsexplored in both chronic pain and substance abuse literatures broadly. The presentstudy had two purposes. First, concurrent risk factors for prescription misuse andsubstance abuse in chronic pain patients were explored, specifically examining whether the addition of emotional factors to the traditionally used risk factors improves predictionof prescription and substance misuse. The present study also experimentally examined whether an enhanced interview condition would lead to increased disclosure ofprescription misuse, other drug use, and traumatic events, by normalizing the experience of substance use and trauma, and engaging in a conversation about confidentiality of the information. Participants completed one session in which they wereassigned to report their prescription misuse, substance use, and trauma in one of the