Trial reportMilitary medicine2021
An Examination of Chronic Pain Indices and the Updated Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental-Disorders-Fifth Edition.
Trial report in Military medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- The mediating role of posttraumatic stress disorder symptoms in pain cognitions among Veterans with chronic pain.Military psychology : the official journal of the Division of Military Psychology, American Psychological Association · 2025Trial
- A Cross-Sectional Analysis of Traumatic Experiences, Post-Traumatic Stress Disorder Symptoms and Chronic Pain in Northern Ireland.European journal of pain (London, England) · 2025Article
- Associations of Posttraumatic Stress Disorder Symptom Clusters and Pain Interference in Post-9/11 Veterans: Exploring Sleep Impairment and Physical Activity as Underlying Mechanisms.International journal of behavioral medicine · 2025Observational
- Co-occurring Chronic Pain and PTSD Among US Military Veterans: Prevalence, Correlates, and Functioning.Journal of general internal medicine · 2024Article
- Article
- Time doesn't heal all: PTSD symptoms exacerbate the relationship between age and pain intensity.Frontiers in psychiatry · 2023Article
- Whole Health Use and Interest Across Veterans With Co-Occurring Chronic Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites.Global advances in health and medicine · 2022Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
introductionChronic pain and post-traumatic stress disorder (PTSD) comorbidity is prevalent among veterans and is associated with increased levels of pain severity and pain-related disability. An improved understanding of the relationship between these co-occurring disorders, in addition to effective integrated treatments, will develop by considering the changes to the PTSD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The current study examined the relationship between the revised PTSD Checklist for DSM-5 (PCL-5) symptom clusters (i.e., intrusion, avoidance, negative alterations in cognition and mood [NACM], and arousal) and chronic pain measurements (i.e., pain severity, interference, and disability). MATERIALS AND
methodsParticipants included 103 veterans (ages 26-70, mean = 45.33) participating in a randomized clinical trial examining the efficacy of an interdisciplinary pain management program for chronic musculoskeletal pain. The study was approved by a university system Institutional Review Board and affiliated healthcare system.
resultsThe participants with a provisional PTSD diagnosis based on PCL-5 responses (N = 76) had significantly greater pain severity, interference, and disability than the participants without a provisional diagnosis (N = 23). Correlations between symptom clusters and pain measurements were mostly significant and positive with varying strengths. The avoidance symptom cluster, however, had relatively weaker correlations with pain measurements and was not significantly associated with the numeric rating scale of pain severity. Path analyses revealed that, after controlling for avoidance symptoms, significant associations remained between NACM and all the pain measurements. After controlling for NACM symptoms, however, there were no significant associations between avoidance symptoms and pain measurements.
conclusionThe current study highlights a need to re-examine the leading theories about the mutual maintenance of these disorders in order to develop effective integrative treatment approaches. PTSD-related avoidance may have a relatively weaker role in co-occurring chronic pain than the other symptom clusters and may have a qualitatively different role than chronic pain-related avoidance. Future research should explore the relationship between the avoidance in PTSD and the avoidance in chronic pain as well as identify which chronic pain measurements are the most useful when examining the relationship between PTSD and chronic pain. The potential impact of trauma-related cognition and mood on chronic pain indicates that this is an important area for intervention and should be considered in the development of integrated treatments for chronic pain and PTSD among veterans.
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