Post-traumatic stress symptom clusters in acute whiplash associated disorder and their prediction of chronic pain-related disability

Background. Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD).Method. Patients seen in a referral clinic (N=571) were evaluated for FM and chronic fatigue syndrome (CFS) criteria. Patients completed questionnaires, and underwent a physical examination and a structured psychiatric evaluation. Critical components of the diagnostic criteria of FM (tender points and diffuse pain) and CFS (persistent debilitating fatigue and four of eight associated symptoms) were examined for their relationship with PTSD.Results. The prevalence of lifetime PTSD was 20% and lifetime MDD was 42%. Patients who had both tender points and diffuse pain had a higher prevalence of PTSD (OR=3·4, 95% CI 2·0–5·8) compared with those who had neither of these FM criteria. Stratification by MDD and adjustment for sociodemographic factors and chronic fatigue revealed that the association of PTSD with FM criteria was confined to those with MDD. Patients with MDD who met both components of the FM criteria had a three-fold increase in the prevalence of PTSD (95% CI 1·5–7·1); conversely, FM patients without MDD showed no increase in PTSD (OR=1·3, 95% CI 0·5–3·2). The components of the CFS criteria were not significantly associated with PTSD.Conclusion. Optimal clinical care for patients with FM should include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.

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Post-traumatic Stress Disorder and Chronic Pain in the Military

Overlapping Pain and Psychiatric Syndromes ◽

10.1093/med/9780190248253.003.0014 ◽

2020 ◽

pp. 189-202

Author(s):

Jordana L. Sommer ◽

Rachel Roy ◽

Pamela L. Holens ◽

Renée El-Gabalawy

Keyword(s):

Chronic Pain ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

The United States ◽

Post Traumatic Stress ◽

Psychosocial Effects ◽

The United Kingdom ◽

Military Populations ◽

Post Traumatic

This chapter summarizes the current literature on post-traumatic stress disorder (PTSD) and chronic pain among military personnel in Canada, the United States, and the United Kingdom, including an overview of clinical features, prevalence, correlates, comorbidity, assessment, and intervention. PTSD and chronic pain are both prevalent among military populations and commonly co-occur; however, prevalence estimates tend to vary in the literature, according to type of assessment, timing of assessment, and subsample of interest. Both PTSD and chronic pain are independently associated with various adverse correlates such as psychiatric and physical health comorbidity, and research suggests there are poorer health and adverse psychosocial effects when these conditions co-occur. These findings highlight the importance of adequate prevention, screening, and interventions among this population.

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Association of fear-avoidance and self-efficacy on pain disability in individuals with co-morbid post-traumatic stress and chronic pain

Journal of Health Psychology ◽

10.1177/1359105320947819 ◽

2020 ◽

pp. 135910532094781 ◽

Cited By ~ 1

Author(s):

Anna Devlin ◽

Sara Casey ◽

Scott Williams ◽

Melita J Giummarra

Keyword(s):

Chronic Pain ◽

Traumatic Stress ◽

Self Efficacy ◽

Fear Avoidance ◽

Post Traumatic Stress ◽

Pain Disability ◽

Stress Symptoms ◽

Lower Pain ◽

Post Traumatic ◽

Indirect Association

This study investigated relationships between post-traumatic stress symptoms (PTSS) and pain disability. Fifty people with chronic pain (probable PTSD, n = 22) completed measures assessing pain interference, PTSS, fear avoidance, and pain self-efficacy. We hypothesized that people with probable PTSD would have higher fear avoidance and lower pain self-efficacy; and that PTSS would be indirectly associated with pain disability via fear avoidance and self-efficacy. People with probable PTSD had higher fear avoidance, but there were no differences in self-efficacy, pain severity or disability. There was an indirect association between PTSS and pain disability via fear avoidance, but not via self-efficacy.

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Post traumatic stress symptom variation associated with sleep characteristics

BMC Psychiatry ◽

10.1186/s12888-020-02550-y ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Quinn M. Biggs ◽

Robert J. Ursano ◽

Jing Wang ◽

Gary H. Wynn ◽

Russell B. Carr ◽

...

Keyword(s):

Traumatic Stress ◽

Post Traumatic Stress ◽

Stress Symptom ◽

Post Traumatic

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Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review

Pain Medicine ◽

10.1093/pm/pnw065 ◽

2016 ◽

pp. pnw065 ◽

Cited By ~ 14

Author(s):

David A. Fishbain ◽

Aditya Pulikal ◽

John E. Lewis ◽

Jinrun Gao

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Evidence Based ◽

Post Traumatic Stress ◽

Post Traumatic

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Towards an exposure-dependent model of post-traumatic stress: longitudinal course of post-traumatic stress symptomatology and functional impairment after the 2011 Oslo bombing

Psychological Medicine ◽

10.1017/s0033291716001860 ◽

2016 ◽

Vol 46 (15) ◽

pp. 3241-3254 ◽

Cited By ~ 10

Author(s):

Ø. Solberg ◽

M. S. Birkeland ◽

I. Blix ◽

M. B. Hansen ◽

T. Heir

Keyword(s):

Social Adjustment ◽

Functional Impairment ◽

Traumatic Stress ◽

Exposed Group ◽

Symptom Clusters ◽

Emotional Numbing ◽

Post Traumatic Stress ◽

Main Driver ◽

Post Traumatic ◽

Over Time

BackgroundOur understanding of the dynamics of post-traumatic stress symptomatology and its link to functional impairment over time is limited.MethodPost-traumatic stress symptomatology (Post-traumatic Checklist, PCL) was assessed three times in 1-year increments (T1, T2, T3) following the Oslo bombing of 22 July, 2011, in directly (n = 257) and indirectly exposed (n = 2223) government employees, together with demographics, measures of exposure and work and social adjustment. The dynamics of post-traumatic stress disorder symptom cluster interplay were examined within a structural equation modelling framework using a cross-lagged autoregressive panel model.ResultsIntrusions at T1 played a prominent role in predicting all symptom clusters at T2 for the directly exposed group, exhibiting especially strong cross-lagged relationships with avoidance and anxious arousal. For the indirectly exposed group, dysphoric arousal at T1 played the most prominent role in predicting all symptom clusters at T2, exhibiting a strong relationship with emotional numbing. Emotional numbing seemed to be the main driver behind prolonged stress at T3 for both groups. Functional impairment was predominately associated with dysphoric arousal and emotional numbing in both groups.ConclusionsFor directly exposed individuals, memories of the traumatic incident and the following intrusions seem to drive their post-traumatic stress symptomatology. However, as these memories lose their potency over time, a sequela of dysphoric arousal and emotional numbing similar to the one reported by the indirectly exposed individuals seems to be the main driver for prolonged post-traumatic stress and functional impairment. Findings are discussed using contemporary models within an exposure-dependent perspective of post-traumatic stress.

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Post-Traumatic Stress Symptoms among Lithuanian Parents Raising Children with Cancer

Children ◽

10.3390/children7090116 ◽

2020 ◽

Vol 7 (9) ◽

pp. 116

Author(s):

Irina Banienė ◽

Nida Žemaitienė

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Symptom Expression ◽

Post Traumatic Stress ◽

Children With Cancer ◽

Stress Symptom ◽

Raising Children ◽

Stress Symptoms ◽

Post Traumatic

Background and objectives: The study aims to evaluate post-traumatic stress symptom expression among Lithuanian parents raising children with cancer, including social, demographic, and medical factors, and to determine their significance for the risk of developing post-traumatic stress disorder. Materials and methods: The study was carried out in two major Lithuanian hospitals treating children with oncologic diseases. The cross-sectional study included 195 parents, out of which 151 were mothers (77.4%) and 44 were fathers (22.6%). Post-traumatic stress symptoms were assessed using the Impact of Event Scale-Revised. To collect the sociodemographic, childhood cancer, and treatment data, we developed a questionnaire that was completed by the parents. Main study results were obtained using multiple linear regression. Results: A total of 75.4% of parents caring for children with cancer had pronounced symptoms of post-traumatic stress disorder. The female gender (β = 0.83, p < 0.001) was associated with an increased manifestation of symptoms, whilst higher parental education (β = −0.21, p = 0.034) and the absence of relapse (β = −0.48, p < 0.001) of the child’s disease reduced post-traumatic stress symptom expression. Conclusions: Obtained results confirmed that experiencing a child’s cancer diagnosis and treatment is extremely stressful for many parents. This event may lead to impaired mental health and increased post-traumatic stress disorder (PTSD) risk; hence, it is necessary to provide better support and assistance to parents of children with cancer.

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