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Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress. Samantha D. Outcalt, PhD; Dennis C. Ang, MD; Jingwei Wu, MS; Christy Sargent, BA; Zhangsheng Yu, PhD; Matthew J. Bair, MD, MS. Aim
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Pain experience of Iraq and Afghanistan Veterans with comorbid chronicpain and posttraumatic stress Samantha D. Outcalt, PhD; Dennis C. Ang, MD; Jingwei Wu, MS; Christy Sargent, BA; Zhangsheng Yu, PhD; Matthew J. Bair, MD, MS
Aim • Identify key aspects of chronic pain, cognitions, and psychological distress associated with comorbid posttraumatic stress disorder (PTSD) among a sample of Veterans. • Relevance • Chronic pain and PTSD co-occur at high rates. • Veterans from recent wars may be particularly vulnerable to both conditions.
Method • Analyzed baseline data from stepped-care intervention trial for chronic musculoskeletal pain. • Compared Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans: • With chronic pain only (n = 173). • With chronic pain and PTSD (n = 68). • Evaluated group differences on: • Pain characteristics. • Pain cognitions. • Psychological distress.
Results • OIF/OEF Veterans with comorbid chronic musculoskeletal pain and PTSD experienced: • Higher pain severity. • Greater pain-related disability. • Increased pain interference. • More maladaptive pain cognitions (e.g., catastrophizing, self-efficacy, pain centrality). • Higher affective distress.
Conclusion • OIF/OEF Veterans may be particularly vulnerable to compounded adverse effects of chronic pain and PTSD. • Results highlight more intense and disabling pain and psychological experience for those with both chronic pain and PTSD than for those without PTSD.