Posttraumatic stress disorder symptoms in youth with vs without chronic pain

Melanie E. Noel · Anna C. Wilson · Amy Lewandowski Holley · Lindsay K. Durkin · Michaela Patton · Tonya Mizell Palermo

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Posttraumatic Stress Disorder Research Musculoskeletal pain and rehabilitation Pediatric Pain Management Techniques

Abstract

Chronic pain and posttraumatic stress disorder (PTSD) symptoms have been found to co-occur in adults; however, research has not examined this co-occurrence in adolescence, when pediatric chronic pain often first emerges. The aims of this study were to compare the frequency and intensity of PTSD symptoms and stressful life events in cohorts of youth with (n = 95) and without (n = 100) chronic pain and their parents and to determine the association between PTSD symptoms, health-related quality of life, and pain symptoms within the chronic pain sample. All participants completed questionnaire measures through an online survey. Findings revealed that youth with chronic pain and their parents had significantly higher levels of PTSD symptoms as compared with pain-free peers. More youth with chronic pain (32%) and their parents (20%) reported clinically significant elevations in PTSD symptoms than youth without chronic pain (8%) and their parents (1%). Youth with chronic pain also reported a greater number of stressful life events than those without chronic pain, and this was associated with higher PTSD symptoms. Among the chronic pain cohort, higher levels of PTSD symptoms were predictive of worse health-related quality of life and were associated with higher pain intensity, unpleasantness, and interference. Results suggest that elevated PTSD symptoms are common and linked to reduced functioning among youth with chronic pain. Future research is needed to examine PTSD at the diagnostic level and the underlying mechanisms that may explain why this co-occurrence exists.

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References

2015The Posttraumatic Stress Disorder Checklist for DSM‐5 (PCL‐5): Development and Initial Psychometric Evaluation 2004Psychometric Properties of the Life Events Checklist 2001The Child PTSD Symptom Scale: A Preliminary Examination of its Psychometric Properties 2013Emotion regulation: Taking stock and moving forward.2001Chronic pain and posttraumatic stress disorder: mutual maintenance?2002PTSD and the Experience of Pain: Research and Clinical Implications of Shared Vulnerability and Mutual Maintenance Models 1991Children and Disaster: Age, Gender, and Parental Effects on PTSD Symptoms 2005Are Reports of Childhood Abuse Related to the Experience of Chronic Pain in Adulthood?

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