Pain and Posttraumatic Stress Symptom Clusters: A Cross-Lagged Study

Frontiers in Psychology

Nancy E. Van Loey¹  Helma W. C. Hofland²  Alette E. E. de Jong³  Vivian de Vries⁴ 

[1] Association of Dutch Burn Centers, Department Psychological and Nursing Research, Beverwijk, Netherlands;Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands;Burn Center, Maasstad Hospital, Rotterdam, Netherlands;Association of Dutch Burn Centers, Department Psychological and Nursing Research, Rotterdam, Netherlands;Burn Center, Red Cross Hospital, Beverwijk, Netherlands;Association of Dutch Burn Centers, Department Psychological and Nursing Research, Beverwijk, Netherlands;Department of Medical Psychology, Red Cross Hospital, Beverwijk, Netherlands;

关键词: burns;    pain;    cross-lagged analyses;    posttraumatic stress disorder;    mutual maintenance;   

DOI  :  10.3389/fpsyg.2021.669231

来源: Frontiers

【 摘 要 】

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 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.

【 授权许可】

CC BY