Diurnal cortisol patterns in chronic pain: Associations with work-family spillover, work, and home stress.

Chronic pain is a prevalent condition with significant impacts on individuals' lives, including heightened stress and impaired physiological functioning. Given that work and family are the two main social domains where stress manifests, this study aimed to investigate the interactions between chronic pain, work-family stressors, and diurnal cortisol patterns to understand how chronic pain affects daily life and physiological stress responses. We identified 1,413 adults with chronic pain and 1,413 matched controls within MIDUS II samples to examine work-family spillover, daily work and home stressors, and cortisol levels across multiple days. The chronic pain group reported more negative work to family spillover and experienced more instances of stressful home events, particularly avoided arguments. These results align with literature suggesting chronic pain exacerbates tensions in close relationships and increases stress. The chronic pain group also had higher cortisol levels cross late-day periods, indicative of hypothalamic-pituitary-adrenal (HPA) axis dysregulation. This dysregulation is associated with poorer health outcomes, including increased inflammation and psychological distress. We did not find any differences in previously identified cortisol profiles, which are higher-level summaries of cortisol levels within each day. We discuss why such difference might not have appeared in this sample.

Sexual Orientation Self-Concept Ambiguity and Alcohol Use Disorder Symptomology: The Roles of Motivated Psychological Distancing and Drinking to Cope.

OBJECTIVE: Women whose sexual identity is not exclusively heterosexual are at risk for alcohol use disorder (AUD) and problematic drinking. A textual analytic approach focusing on motivated psychological distancing in language style use was used to detect sexual minority women who are at greatest risk for an AUD. METHOD: Young adult women (N = 254) were asked to complete a self-report measure of sexual orientation self-concept ambiguity as well as free-write about their sexuality. In addition, they completed a questionnaire assessing AUD symptoms according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The Linguistic Inquiry and Word Count (LIWC) program assessed language markers within participant-written essays that reflected acute states of aversive self-focus (i.e., fewer first-person pronouns, fewer present-tense verbs). RESULTS: Drinking to cope with negative affectivity mediated the relationship between sexual orientation self-concept ambiguity and AUD symptomology. This indirect effect was conditional, moderated by higher use of language reflecting motivated psychological distancing, such that the indirect effect was significant only for women whose writing included fewer instances of first-person pronouns and present-tense verbs (-1 SD) compared with those with greater instances of first-person pronouns and present-tense verbs (+1 SD), reflecting motivated psychological distancing. CONCLUSIONS: Sexual minority women are at an increased risk for AUD. Further, this study suggests mechanisms that may exacerbate the relationship between sexual identity uncertainty and problematic drinking. The study presents a novel method of identifying individuals most at risk for alcohol misuse: detecting aversive self-focus in language style and word choice.