Synergistic effects of pain and alcohol use in relation to depressive and anxiety symptoms among Latinos in primary care

Daniel J. Paulus, Andres G. Viana, Joseph W. Ditre, Jafar Bakhshaie, Monica Garza, Jodi Berger Cardoso, Jeanette Valdivieso, Melissa Ochoa-Perez, Chad Lemaire, Michael J. Zvolensky

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Although past work has shown that alcohol use co-occurs with anxiety/depression among Latinos, little work has examined the variables that qualify such associations. The present investigation sought to address whether pain severity (i.e. pain intensity and/or pain-related disability, respectively) moderated relations between hazardous drinking and depressive/anxious arousal symptoms among an economically disadvantaged Latino sample recruited from a primary care medical setting. Participants included 253 adult Latinos (Mage = 38.5 years, SD = 10.8; 86.6% female) who attended a community-based primary care clinic. There was a significant interaction of hazardous drinking with pain intensity in relation to depressive symptoms and significant interactions of hazardous drinking and pain-related disability in relation to depressive and anxious arousal symptoms. Hazardous drinking was associated with more severe depressive/anxious arousal symptoms only when pain intensity/disability was high. This is the first study to demonstrate the moderating role of pain intensity and disability in associations between hazardous drinking and anxiety/depression among Latinos in a primary care medical setting.

Original languageEnglish (US)
Pages (from-to)478-492
Number of pages15
JournalCognitive Behaviour Therapy
Issue number6
StatePublished - Nov 2 2017


  • Pain
  • alcohol
  • comorbidity
  • health disparity
  • transdiagnostic

ASJC Scopus subject areas

  • Clinical Psychology


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