A Cross-Sectional Analysis of Traumatic Experiences, Post-Traumatic Stress Disorder Symptoms and Chronic Pain in Northern Ireland

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-05-29 DOI:10.1002/ejp.70044

Kevin E. Vowles, Christina Mallett, Jason Brooks, Emma Berry, Danielle Rainey, Claire Briggs, Maura McCarron

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Abstract

Background

Chronic pain and post-traumatic stress disorder (PTSD) are frequently comorbid and are associated with more significant pain-related disruption than chronic pain alone. It is not clear if these disruptions are due to traumatic experience or specific symptoms related to PTSD.

Methods

This issue was evaluated in a large sample (N = 1367) of individuals with chronic pain presenting for treatment at an interdisciplinary pain rehabilitation service. As a secondary objective, the comorbidity of chronic pain and PTSD in Northern Ireland (NI) was also examined given high regional prevalence rates. Participants completed a PTSD screening measure, along with measures of pain interference, social functioning, pain anxiety, pain self-efficacy, pain intensity and depression.

Results

Screening indicated that 46.4% had never experienced a traumatic event, 22.5% had experienced a traumatic event but screened negative for PTSD and 31.1% screened positive for PTSD. Following identification of covariates, a Multivariate Analysis of Covariance examined differences in dependent measures by PTSD category, which yielded a similar pattern of results across measures. The group that screened positive for PTSD reported worse functioning and more disruptions in comparison to the other two PTSD groups, with the latter groups not differing on any measure.

Conclusions

These analyses indicate that poorer functioning was not associated with trauma exposure alone; rather, it was experienced in association with PTSD symptoms. Further, comorbidity rates of PTSD and chronic pain in this NI dwelling sample were at the high end of the range in relation to previous work and exceeded past year regional prevalence estimates.

Significance

PTSD assessment in those with chronic pain may be best served by evaluating the impact of these experiences on function, rather than focusing on the traumatic experiences in isolation. Further, there is scope to develop integrated chronic pain and PTSD treatments.

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北爱尔兰创伤经历、创伤后应激障碍症状和慢性疼痛的横断面分析

慢性疼痛和创伤后应激障碍（PTSD）通常是共病，与单独的慢性疼痛相比，与疼痛相关的破坏更显著。目前尚不清楚这些中断是由于创伤经历还是与创伤后应激障碍相关的特定症状。方法对在跨学科疼痛康复服务机构接受治疗的慢性疼痛患者的大样本（N = 1367）进行评估。作为次要目标，慢性疼痛和创伤后应激障碍在北爱尔兰（NI）的合并症也检查了高区域患病率。参与者完成了创伤后应激障碍筛查测试，以及疼痛干扰、社会功能、疼痛焦虑、疼痛自我效能、疼痛强度和抑郁程度的测试。结果46.4%的人从未经历过创伤性事件，22.5%的人经历过创伤性事件，但PTSD筛查呈阴性，31.1%的人PTSD筛查呈阳性。在确定了协变量之后，进行了多变量协方差分析，检查了创伤后应激障碍类别依赖测量的差异，得出了类似的结果模式。与其他两组相比，PTSD筛查呈阳性的一组报告功能更差，干扰更多，后两组在任何指标上都没有差异。这些分析表明，较差的功能并不仅仅与创伤暴露有关；相反，它与创伤后应激障碍症状有关。此外，在这个NI居住样本中，创伤后应激障碍和慢性疼痛的合并率与以前的工作相比处于范围的高端，超过了去年的区域患病率估计。对慢性疼痛患者的创伤后应激障碍评估最好是评估这些经历对功能的影响，而不是孤立地关注创伤经历。此外，还有开发综合慢性疼痛和创伤后应激障碍治疗的空间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.