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Relationship between Extreme Pain Phenotypes and Psychosocial Outcomes in Persons with Chronic Pain following Traumatic Brain Injury: A NIDILRR and VA TBI Model Systems Collaborative Project
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2024
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Source: J Head Trauma Rehabil. 39(1):56-67
[PDF-586.85 KB]
Details:
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Alternative Title:J Head Trauma Rehabil
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Personal Author:
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Description:Objective:
To examine the relationship between extreme pain phenotypes (interference and improvement) and psychosocial outcomes among those with chronic pain after traumatic brain injury (TBI).
Setting:
Community.
Participants:
1,762 TBI Model Systems (TBIMS) participants 1-30 years post-injury reporting chronic pain.
Design:
Multi-site, cross-sectional observational cohort study.
Primary Measure(s):
Life satisfaction, post-traumatic stress, depression and anxiety symptoms, sleep and participation, Brief Pain Inventory (BPI) interference scale, Patients Global Impression of Change (PGIC).
Results:
Persons in the extreme high interference phenotype (vs extreme low interference phenotype) and/or extreme no change phenotype (vs extreme improvement phenotype) had poorer psychosocial outcomes, with extreme pain interference phenotypes having a larger effect on outcomes than extreme perceived improvement phenotypes. After controlling for covariates, large effect sizes (ES) related to pain interference were observed for post-traumatic stress symptomology (ES = −1.14), sleep quality (ES = −1.10), depression (ES = −1.08), anxiety (ES = −0.82), and life satisfaction (ES = 0.76); effect sizes for participation outcomes, although significant, were relatively small (ES = 0.21-0.36). Effect sizes related to perceived improvement were small for life satisfaction (ES = 0.20) and participation (ES = 0.16-0.21) outcomes. Pain intensity was identified as a meaningful confounding factor of the relationships between extreme phenotypes and post-traumatic stress, depression, anxiety, and sleep quality.
Conclusions:
Examination of extreme phenotypes provides important insights on the experience of individuals living with chronic pain and TBI. Results suggest that the relationships among a variety of characteristics of the person, their experience with pain, and treatment of pain is complex. Further research is needed to better understand these complex relationships and how differences in pain interference and perceived improvement from treatment can assist in assessment and treatment of chronic pain after TBI.
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Source:
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Pubmed ID:38032831
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Pubmed Central ID:PMC10842936
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Document Type:
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Funding:
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Volume:39
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Issue:1
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