The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain

Abstract

Recent studies have reported a high prevalence of symptoms of post-traumatic stress disorder (PTSD) among individuals with chronic pain. Studies suggest that persons with pain and PTSD also display higher levels of affective disturbance. In the present study we examined self-reports of pain, affective disturbance, and disability among pain patients with and without symptoms of PTSD. Patients without PTSD symptoms were further subdivided into persons whose pain was the result of an accident or insidious in onset. Thus, three groups were examined: (1) persons with accident related pain and high PTSD symptoms (Accident/High PTSD); (2) persons with no or few symptoms of PTSD whose pain was accident related (Accident/Low PTSD); and (3) patients whose pain was not accident related and did not have PTSD symptoms (No Accident). No Accident patients were older than persons with accident related injuries, and both accident related pain groups were more likely than No Accident patients to be involved in litigation or receiving compensation. Thus, these variables were controlled for in the statistical analyses. Self-report of pain was also included as a covariate in the analyses examining group differences in affective disturbance and disability. Accident/High PTSD patients displayed higher levels of self-reported pain compared to the other two groups. The Accident/High PTSD group also had the highest levels of affective disturbance. Both accident groups tended to report greater disability compared to patients whose pain was not accident related. These findings suggest that PTSD symptoms in chronic pain patients are associated with increased pain and affective distress. Accident related pain, even without the presence of PTSD symptoms, appears to be associated with greater disability. The results indicate that the identification and treatment of PTSD symptoms in refractory pain patients may be a critical albeit subtle factor in the effective management of suffering and disability in this population.

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

“…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.…”

An examination of the relationship between chronic pain and post-traumatic stress disorder

“…Hospitalized burn patients have been found to have high rates of PTSD (45%) at 12 months postinjury [38]. Geisser, Roth, Bachman, and Eckert examined the self-report of pain, affective distress, and disability in pain patients with and without PTSD symptoms [39]. Their results indicated that patients with accident-related pain and high PTSD symptoms reported higher levels of pain and affective distress relative to patients with accident-related pain and without PTSD, or nonaccident-related pain.…”

Hypnosis for Chronic Pain Management

“…In our sample, FM patients seemed to have experienced more intense suffering-related emotions involving depression and frustration, and to have undergone more traumatic experiences in their lives, possibly generating oversensitivity to painful perception [46,70]. In the fields of psychosomatics and health psychology, researchers have long known that traumatic experiences, anxiety and stress as well as psychological disturbances can exacerbate disease processes or show poor treatment outcomes [71][72][73][74].…”