Department of Psychiatry, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA Department of Veterans Affairs, New Jersey Health Care System, Lyons, NJ, USA.
Pain. 2012 Oct;153(10):2055-2060. doi: 10.1016/j.pain.2012.06.015. Epub 2012 Aug 3.
A recent cross-sectional study of National Guard troops found that pain and pain catastrophizing were prevalent and highly correlated with posttraumatic stress disorder (PTSD). At issue in the present study was whether pain and catastrophizing before military deployment could account for individual differences in PTSD symptoms after deployment. An anonymous survey was administered to a population sample of New Jersey National Guard troops before they were sent overseas and again when they returned home (1 year later). The survey included a validated PTSD screening questionnaire, numerical ratings of pain intensity, and a measure of pain catastrophizing. A cohort of 922 National Guard members completed the survey before and after deployment. An uncontrolled analysis indicated that pain and catastrophizing before deployment were significantly but modestly associated with PTSD symptoms after deployment (accounting for 4.5% and 1.3% of the variance, respectively). A hierarchical regression model that controlled for sex, preexisting PTSD symptoms, and recent combat found that pain but not pain catastrophizing explained variance in postdeployment PTSD. The size of the effect, however, was negligible (0.8%, p<.01). Consistent with previous research, a cross-sectional analysis revealed that postdeployment pain and catastrophizing successfully accounted for unique variance in postdeployment PTSD. The failure of longitudinal predictors in the present study, therefore, cannot be attributed to insensitive screening instruments. These findings offer little or no support for the hypothesis that predeployment pain and catastrophizing can account for individual differences in PTSD after exposure to combat trauma.
一项针对国民警卫队士兵的横断面研究发现，疼痛和疼痛灾难化普遍存在，并与创伤后应激障碍（PTSD）高度相关。本研究关注的问题是，军事部署前的疼痛和灾难化是否可以解释部署后 PTSD 症状的个体差异。对新泽西州国民警卫队士兵进行了一项匿名调查，在他们被派往海外之前和返回国内（1 年后）再次进行调查。该调查包括一个经过验证的 PTSD 筛查问卷、疼痛强度的数字评分和疼痛灾难化的测量。922 名国民警卫队成员完成了部署前后的调查。一项非控制分析表明，部署前的疼痛和灾难化与部署后的 PTSD 症状显著但适度相关（分别解释了 4.5%和 1.3%的方差）。一个控制了性别、预先存在的 PTSD 症状和近期战斗的层次回归模型发现，疼痛而不是疼痛灾难化解释了部署后 PTSD 的方差。然而，效应的大小可以忽略不计（0.8%，p<.01）。与之前的研究一致，横断面分析表明，部署后的疼痛和灾难化成功地解释了部署后 PTSD 的独特方差。因此，本研究中纵向预测因子的失败不能归因于不敏感的筛查工具。这些发现几乎没有或没有支持这样的假设，即接触战斗创伤前的疼痛和灾难化可以解释 PTSD 后的个体差异。
