Existential distress among individuals with co-occurring chronic pain and PTSD.

Objective: Co-occurring chronic pain and posttraumatic stress disorder (PTSD) affects mental and physical health functioning, disrupting individuals' ability to engage in activities that limit existential distress (i.e., distress associated with encountering one's limitations). While existential distress is a recognized phenomenon of chronic pain and PTSD, little empirical data are available focused on these concepts within the population. The present study objectives were to characterize and compare existential distress (death anxiety, existential isolation, true-self incongruence, inauthenticity, low self-concept clarity, and limited future time perspective) between four groups: control, chronic pain only, PTSD only, and co-occurring chronic pain and PTSD.

Method: A total of 158 (average age = 40.2 years, SD = 13.2) individuals were included in the study. General linear models were run to assess differences in criterion variables across diagnostic groups, adjusting for covariates.

Results: Individuals with co-occurring chronic pain and PTSD endorsed more severe existential distress compared with controls and chronic pain only (significant Cohen's ds ranging from 0.35 to 0.67). However, there were no differences between the PTSD only group and those with co-occurring chronic pain and PTSD.

Conclusions: The present study provides evidence that existential distress may be an important factor among individuals with co-occurring chronic pain and PTSD. Moreover, PTSD may be more strongly associated with existential distress compared with chronic pain. Results show that it may be beneficial to focus on existential distress when treating co-occurring chronic pain and PTSD. More research is needed to validate these results and examine existential distress in clinical settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).