The role of pain and socioenvironmental factors on posttraumatic stress disorder symptoms in traumatically injured adults: A 1-year prospective study

Details

• Alternative Title:
  J Trauma Stress
• Personal Author:
  Webb, E. Kate ; Ward, Richard T. ; Mathew, Abel S. ; Price, Matthew ; Weis, Carissa N. ; Trevino, Colleen M. ; deRoon-Cassini, Terri A. ; Larson, Christine L.
• Description:
  Approximately 20% of individuals who experience a traumatic injury will subsequently develop posttraumatic stress disorder (PTSD). Physical pain following traumatic injury has received increasing attention as both a distinct, functionally debilitating disorder and a comorbid symptom related to PTSD. Studies have demonstrated that both clinician-assessed injury severity and patient pain ratings can be important predictors of nonremitting PTSD; however, few have examined pain and PTSD alongside socioenvironmental factors. We postulated that both area- and individual-level socioeconomic circumstances and lifetime trauma history would be uniquely associated with PTSD symptoms and interact with the pain-PTSD association. To test these effects, pain and PTSD symptoms were assessed at four visits across a 1-year period in a sample of 219 traumatically injured participants recruited from a Level 1 trauma center. We used a hierarchal linear modeling approach to evaluate whether (a) patient-reported pain ratings were a better predictor of PTSD than clinician-assessed injury severity scores and (b) socioenvironmental factors, specifically neighborhood socioeconomic disadvantage, individual income, and lifetime trauma history, influenced the pain-PTSD association. Results demonstrated associations between patient-reported pain ratings, but not clinician-assessed injury severity scores, and PTSD symptoms, R| | | = .65. There was a significant interaction between neighborhood socioeconomic disadvantage and pain such that higher disadvantage decreased the strength of the pain-PTSD association but only among White participants, R| | | = .69. Future directions include testing this question in a larger, more diverse sample of trauma survivors (e.g., geographically diverse) and examining factors that may alleviate both pain and PTSD symptoms.
• Subjects:
  Adult Humans Injury Severity Score Pain Prospective Studies Stress Disorders, Post-Traumatic Survivors
• Source:
  J Trauma Stress. 35(4):1142-1153
• Pubmed ID:
  35238074
• Pubmed Central ID:
  PMC9357124
• Document Type:
  Journal Article
• Funding:
  F32 MH127793/MH/NIMH NIH HHSUnited States/ ; TL1 TR001437/TR/NCATS NIH HHSUnited States/ ; R01 MH106574/MH/NIMH NIH HHSUnited States/ ; U01 CE002944/CE/NCIPC CDC HHSUnited States/ ; UL1 TR001436/TR/NCATS NIH HHSUnited States/
• Volume:
  35
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:a5c95ad501b1299b0c908b2a4c8249755d5e0133bbbd19f9c03284f4858925b89e385871265b7fb0c3c222991d7a1724c62d3c29cfef73cd7628c24dc412de5c
• Download URL:
  https://stacks.cdc.gov/view/cdc/170014/cdc_170014_DS1.pdf
• File Type:
  [PDF - 359.46 KB ]