Document Detail

The relationship between PTSD and chronic pain: mediating role of coping strategies and depression.
MedLine Citation:
PMID:  23398939     Owner:  NLM     Status:  MEDLINE    
People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into 2 groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures of pain severity, interference, emotional functioning, and coping strategies. Those with current PTSD reported significantly greater pain severity and pain interference, had more symptoms of depression, and were more likely to meet diagnostic criteria for a current alcohol or substance use disorder (all p-values <.01). Participants with PTSD reported more use of several coping strategies, including guarding, resting, relaxation, exercise/stretching, and coping self-statements. Illness-focused pain coping (i.e., guarding, resting, and asking for assistance) and depressive symptoms jointly mediated the relationship between PTSD and both pain interference (total indirect effect=0.194, p<.001) and pain severity (total indirect effect=0.153, p=.004). Illness-focused pain coping also evidenced specific mediating effects, independent of depression. In summary, specific pain coping strategies and depressive symptoms partially mediated the relationship between PTSD and both pain interference and severity. Future research should examine whether changes in types of coping strategies after targeted treatments predict improvements in pain-related function for chronic pain patients with concurrent PTSD.
Benjamin J Morasco; Travis I Lovejoy; Mary Lu; Dennis C Turk; Lynsey Lewis; Steven K Dobscha
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2013-01-11
Journal Detail:
Title:  Pain     Volume:  154     ISSN:  1872-6623     ISO Abbreviation:  Pain     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-26     Completed Date:  2013-09-19     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  609-16     Citation Subset:  IM    
Copyright Information:
Published by Elsevier B.V.
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MeSH Terms
Adaptation, Psychological / physiology*
Chronic Pain / complications*,  epidemiology,  psychology*
Cross-Sectional Studies
Depression / epidemiology,  etiology*,  rehabilitation*
Hospitals, Veterans / statistics & numerical data
Middle Aged
Models, Theoretical
Stress Disorders, Post-Traumatic / complications*,  epidemiology,  psychology*
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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