Abstract
Symptoms of post-traumatic stress disorder (PTSD) are a common comorbidity in patients
with a history of accident-related chronic pain and depression. However, little is
known regarding the influence of PTSD in contributing to the affective distress, pain
experience, and disability associated with chronic pain in this population. This study
used structural equation modeling to examine 3 models that assess these relations
in a sample of chronic pain patients with accident-related pain. Subjects were assessed
for pain experience, depressive symptoms, anxiety, PTSD symptoms, pain disability,
and relevant demographic variables. Pearson correlations indicated that symptoms of
depression were significantly related to more severe pain, disability, and PTSD symptoms.
PTSD symptoms were significantly associated with higher disability. The model of best
fit indicated that after controlling for the influence of anxiety on the dependent
measures, PTSD symptoms have a direct influence on severity of depressive symptoms,
whereas depressive symptoms have a direct influence on pain intensity and an indirect
impact on pain intensity by way of their effect on disability. These data point to
the importance of unresolved PTSD symptoms in contributing to the level of depression,
pain, and disability exhibited by chronic pain patients and highlight the need to
consider directed and primary treatment of PTSD in pain rehabilitation programs.
Perspective
This study highlights the impact of symptoms of PTSD on levels of depression, disability,
and pain in patients with pain secondary to physical injury. Our results suggest that
pain rehabilitation programs provide directed interventions for PTSD symptoms among
this population to improve pain treatment outcomes.
Key words
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Article info
Publication history
Published online: March 17, 2008
Accepted:
January 19,
2008
Received in revised form:
January 15,
2008
Received:
July 17,
2007
Identification
Copyright
© 2008 American Pain Society. Published by Elsevier Inc. All rights reserved.
