An examination of the co-morbidity between chronic pain and posttraumatic stress disorder on U.S. Veterans.

Otis, John D.; Gregor, Kristin; Hardway, Christina; Morrison, Jay A.; Scioli, Erica R.; Sanderson, Kristen

doi:10.1037/a0020512

Cited by 74 publications

(64 citation statements)

References 27 publications

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“…Previous literature has demonstrated associations between PTSD and intensified pain severity, disability, and interference [45][46][47]; however, at least one study did not corroborate this finding [4]. Results from the current study contribute further evidence to support the relationship between PTSD comorbidity and intensified pain features.…”

Section: Outcalt Et Al Veterans With Comorbid Chronic Pain and Ptsdsupporting

confidence: 70%

“…Increasingly, the literature is illuminating more about the prevalence, costs, and impact of the comorbidity between these two conditions. In a recent study of Veterans receiving treatment for chronic pain, PTSD was identified in 49 percent of the sample [4]. Among Veterans seeking mental health treatment for PTSD, comorbid chronic pain was diagnosed in 66 percent of the patients studied [5].…”

Section: Introductionmentioning

confidence: 99%

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Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Outcalt

Ang

et al. 2014

J Rehabil Res Dev

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Abstract-Chronic pain and posttraumatic stress disorder (PTSD) co-occur at high rates, and Veterans from recent wars in Iraq and Afghanistan may be particularly vulnerable to both conditions. The objective of this study was to identify key aspects of chronic pain, cognitions, and psychological distress associated with comorbid PTSD among this sample of Veterans. Baseline data were analyzed from a randomized controlled trial testing a stepped-care intervention for chronic musculoskeletal pain. Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans with chronic pain only (n = 173) were compared with those with chronic pain and clinically significant posttraumatic stress symptoms (n = 68). Group differences on pain characteristics, pain cognitions, and psychological distress were evaluated. Results demonstrated that OIF/OEF Veterans with comorbid chronic musculoskeletal pain and PTSD experienced higher pain severity, greater painrelated disability and increased pain interference, more maladaptive pain cognitions (e.g., catastrophizing, self-efficacy, pain centrality), and higher affective distress than those with chronic pain alone. Veterans of recent military conflicts in Iraq and Afghanistan may be particularly vulnerable to the compounded adverse effects of chronic pain and PTSD. These results highlight a more intense and disabling pain and psychological experience for those with chronic pain and PTSD than for those without PTSD. Clinical

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Section: Outcalt Et Al Veterans With Comorbid Chronic Pain and Ptsdsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Outcalt

Ang

et al. 2014

J Rehabil Res Dev

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show abstract

“…A recent systematic review (Brennstuhl, Tarquinio, & Montel, 2015) included all studies on the relationship between chronic pain and PTSD in populations without any specific underlying somatic disorder and found 24 articles meeting the inclusion criteria. Of these articles, only one study (Otis et al, 2010) recruited participants from a pain management programme. These participants were all military veterans and the findings from this study might not be applicable to a civilian population.…”

Section: Introductionmentioning

confidence: 99%

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Siqveland

Ruud

Hauff

2017

European Journal of Psychotraumatology

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Background: Trauma exposure and post-traumatic stress disorder (PTSD) are risk factors for chronic pain. Objective: This study investigated how exposure to intentional and non-intentional traumatic events and PTSD are related to pain severity and outcome of treatment in chronic pain patients. Methods: We assessed exposure to potentially traumatizing events, psychiatric diagnosis with structured clinical interview, and pain severity in 63 patients at a secondary multidisciplinary pain clinic at the beginning of treatment, and assessed level of pain at follow up. Exposure to potentially traumatizing events and PTSD were regressed on pain severity at the initial session and at follow up in a set of multiple regression analysis. Results: The participants reported exposure to an average of four potentially traumatizing events, and 32% had PTSD. Exposure to intentional traumatic events and PTSD were significantly associated with more severe pain, and PTSD significantly moderated the relationship between trauma exposure and pain (all p < .05). The treatment programme reduced pain moderately, an effect that was unrelated to trauma exposure and PTSD. Conclusions: Trauma exposure is related to chronic pain in the same pattern as to mental disorders, with intentional trauma being most strongly related to pain severity. PTSD moderated the relationship between trauma exposure and pain. While pain patients with PTSD initially report more pain, they responded equally to specialist pain treatment as persons without PTSD.

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“…diabetes) and osteoarthritis. 17 Conversely, Otis et al 18 studied 149 veterans in a psychology pain management programme. Diagnostic criteria for PTSD were met in 49% of cases using the PTSD Checklist -Military version (PCL-M).…”

Section: Pain and Comorbid Mental Health Problemsmentioning

confidence: 99%

“…Diagnostic criteria for PTSD were met in 49% of cases using the PTSD Checklist -Military version (PCL-M). 18 Two key theories have been proposed to account for the high comorbidity between PTSD and chronic pain. The 'shared vulnerability' hypothesis proposes that an underlying trait, such as anxiety sensitivity (the fear that anxiety symptoms are harmful) predisposes patients to both pain and PTSD.…”

Section: Pain and Comorbid Mental Health Problemsmentioning

confidence: 99%

Veterans and chronic pain

Gauntlett‐Gilbert

Wilson

2013

British Journal of Pain

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Summary points1. Musculoskeletal problems are the commonest reason for medical discharge in all the British armed forces. By definition, these problems are chronic and resistant to treatment. 2. Pain is also common in veterans who have experienced severe injuries (polytrauma), often accompanied by post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) orpostconcussive syndrome. 3. In veterans seeking treatment for chronic pain, PTSD is common. There is also evidence for elevated levels of alcohol misuse in veterans who have been deployed to conflict. However, most veterans do not have pain, PTSD or alcohol problems. 4. Pain clinicians would benefit from training in meeting veterans' needs, in order to promote their engagement and successful treatment. This should include countering stereotypes, information about the military and support for the assessment and onward referral of PTSD and alcohol problems.

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An examination of the co-morbidity between chronic pain and posttraumatic stress disorder on U.S. Veterans.

Cited by 74 publications

References 27 publications

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Veterans and chronic pain

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