Date of Award

Fall 12-2021

Document Type


Degree Name

Doctor of Philosophy (PhD)




Virginia Consortium Program in Clinical Psychology

Committee Director

Michelle L. Kelley

Committee Member

Karen Y. Holmes

Committee Member

Robin J. Lewis

Committee Member

Skye O. Margolies


United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found between levels of pain and poor sleep quality, pain-related beliefs about sleep and poor sleep quality, and pain and pain-related beliefs about sleep. A negative correlation was found between levels of pain acceptance and pain-related beliefs about sleep – that is, higher levels of acceptance of one’s pain was associated with lower pain-related thoughts regarding one’s sleep. Additionally, pain-related beliefs about sleep were found to mediate the relationship between pain and sleep quality. This finding reinforces the importance of addressing pain-related thoughts about sleep among post-9/11 veterans. Although it was hypothesized that greater acceptance of chronic pain would moderate the relationship between pain and sleep, this hypothesis was not supported. Findings from this study provide vital information to help inform treatment in efforts to assist co-occurring conditions related to sleep and chronic pain commonly found in veterans. The relationship between pain and sleep among recent-era veterans is complex; thus, additional research is needed to further elucidate this relationship and continue to examine specific treatments to more effectively assist post-9/11 veterans with comorbid pain and sleep difficulties.


The VIRGINIA CONSORTIUM PROGRAM IN CLINICAL PSYCHOLOGY is a joint program of Eastern Virginia Medical School, Norfolk State University, and Old Dominion University.


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