Pain and Posttraumatic Stress Symptom Clusters: A Cross-Lagged Study
de Vries, V.; de Jong, A.E.E.; Hofland, H.W.C.; Van Loey, N.E.E.
(2021) Frontiers in Psychology, volume 12, pp. 1 - 8
(Article)
Abstract
Pain and posttraumatic stress disorder (PTSD) frequently co-occur but underlying mechanisms are not clear. This study aimed to test the development and maintenance of pain and PTSD symptom clusters, i.e., intrusions, avoidance, and hyperarousal. The longitudinal study included 216 adults with burns. PTSD symptom clusters, indexed by the Impact of
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Event Scale-Revised (IES-R), and pain, using a graphic numerical rating scale (GNRS), were measured during hospitalization, 3 and 6 months post-burn. Cross-lagged panel analysis was used to test the relationships between pain and PTSD symptom clusters. Cross-lagged results showed that in-hospital intrusions predicted pain and avoidance 3 months post-burn. In-hospital pain predicted intrusions and avoidance 3 months post-burn and a trend was found for hyperarousal (90% CI). In the second wave, intrusions predicted pain and hyperarousal. Pain predicted hyperarousal. This study provides support for an entangled relationship between pain and PTSD symptoms, and particularly subscribes the role of intrusions in this bidirectional relationship. To a lesser extent, hyperarousal was unidirectionally related to pain. These results may subscribe the driving role of PTSD, particularly intrusions, which partly supports the Perpetual Avoidance Model.
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Keywords: burns, cross-lagged analyses, mutual maintenance, pain, posttraumatic stress disorder, General Psychology
ISSN: 1664-1078
Publisher: Frontiers Media S.A.
Note: Funding Information: This study is the result of collaborative efforts of the psychosocial research group represented by: Mr. M. Bremer and Mrs. G. Bakker, Martini Hospital Groningen, the Netherlands, Mrs. A. Boekelaar, Red Cross Hospital, Beverwijk, the Netherlands, Mrs. A. van de Steenoven, Maasstadhospital, Rotterdam, the Netherlands, Mrs. A.S. Goemanne and Mrs. H. Hendrickx, University Hospital Gent, Belgium, Mrs. E. Vandermeulen, Military Hospital, Brussels, Belgium. Funding. This study was funded by Fonds NutsOhra grant numbers 0901-057 and 1101-035. Funding Information: This study was funded by Fonds NutsOhra grant numbers 0901-057 and 1101-035. Publisher Copyright: © Copyright © 2021 de Vries, de Jong, Hofland and Van Loey.
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