Highlights
- •We examine longitudinal models of pain and PTSD symptoms among military personnel.
- •Pain and PTSD symptoms are strongly associated with one another across time.
- •PTSD symptoms show a particularly strong influence on subsequent pain symptoms.
Abstract
Military personnel returning from conflicts in Iraq and Afghanistan often endorse
pain and posttraumatic stress disorder (PTSD) symptoms, either separately or concurrently.
Associations between pain and PTSD symptoms may be further complicated by blast exposure
from explosive munitions. Although many studies have reported on the prevalence and
disability associated with polytraumatic injuries following combat, less is known
about symptom maintenance over time. Accordingly, this study examined longitudinal
interactive models of co-occurring pain and PTSD symptoms in a sample of 209 military
personnel (mean age = 27.4 years, standard deviation = 7.6) who experienced combat-related
blast exposure. Autoregressive cross-lagged analysis examined longitudinal associations
between self-reported pain and PTSD symptoms over a 1-year period. The best-fitting
covariate model indicated that pain and PTSD were significantly associated with one
another across all assessment periods, χ2 (3) = 3.66, P = .30, Tucker-Lewis index = .98, comparative fit index = 1.00, root mean squared
error of approximation = .03. PTSD symptoms had a particularly strong influence on
subsequent pain symptoms. The relationship between pain and PTSD symptoms is related
to older age, race, and traumatic brain injury characteristics. Results further the
understanding of complex injuries among military personnel and highlight the need
for comprehensive assessment and rehabilitation efforts addressing the interdependence
of pain and co-occurring mental health conditions.
Perspective
This longitudinal study demonstrates that pain and PTSD symptoms strongly influence
one another and interact across time. These findings have the potential to inform
the integrative assessment and treatment of military personnel with polytrauma injuries
and who are at risk for persistent deployment-related disorders.
Key words
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Article info
Publication history
Published online: July 16, 2014
Accepted:
July 1,
2014
Received in revised form:
May 28,
2014
Received:
March 14,
2014
Footnotes
Writing of this manuscript was supported in part by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs, United States Government (K.J.S.), the Defense and Veterans Brain Injury Center, and by a grant by the U.S. Army Medical Research and Material Command, Congressionally Directed Medical Research Program (grant no. W191ZSQ8118N6200001; W.C.W.).
The authors declare that they have no conflicts of interest to disclose.
The views expressed are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or any of the institutions with which the authors are affiliated.
Identification
Copyright
Published by Elsevier Inc.
