Vowles Kevin E, Mallett Christina, Brooks Jason, Berry Emma, Rainey Danielle, Briggs Claire, McCarron Maura
School of Psychology, Queen's University Belfast, Belfast, UK.
Centre for Pain Rehabilitation, Belfast Health and Social Care Trust, Belfast, UK.
Eur J Pain. 2025 Jul;29(6):e70044. doi: 10.1002/ejp.70044.
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.
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.
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.
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.
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.
慢性疼痛与创伤后应激障碍（PTSD）常常并发，且与仅患有慢性疼痛相比，会导致更严重的与疼痛相关的功能障碍。目前尚不清楚这些功能障碍是由创伤经历还是与PTSD相关的特定症状所致。
在一家跨学科疼痛康复服务机构接受治疗的大量慢性疼痛患者样本（N = 1367）中对这一问题进行了评估。作为次要目标，鉴于北爱尔兰（NI）地区的患病率较高，还对该地区慢性疼痛与PTSD的共病情况进行了研究。参与者完成了一项PTSD筛查量表，以及疼痛干扰、社会功能、疼痛焦虑、疼痛自我效能感、疼痛强度和抑郁的测量。
筛查结果显示，46.4%的人从未经历过创伤事件，22.5%的人经历过创伤事件但PTSD筛查呈阴性，31.1%的人PTSD筛查呈阳性。在确定协变量后，进行了多变量协方差分析，以检验不同PTSD类别在相关测量指标上的差异，各项测量结果呈现出相似的模式。与其他两个PTSD组相比，PTSD筛查呈阳性的组报告的功能较差且功能障碍更多，而后两组在任何测量指标上均无差异。
这些分析表明，较差的功能并非仅与创伤暴露有关；相反，它与PTSD症状相关。此外，在这个居住在北爱尔兰的样本中，PTSD与慢性疼痛的共病率处于以往研究范围的较高水平，且超过了过去一年该地区的患病率估计。
对于慢性疼痛患者，评估这些经历对功能的影响可能比单独关注创伤经历更有助于进行PTSD评估。此外，有必要开发综合的慢性疼痛和PTSD治疗方法。
