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In a sample of 70 chronic pain patients, hierarchical multiple regression analyses were utilized to assess the additive and interactive contributions of pain severity and psychological distress variables to neurocognitive performance across attention and concentration, memory, and reasoning ability domains. Although the full model predicting attention and concentration was found to be significant, there was no significant contribution of pain severity, psychological distress, or the Pain Severity x Psychological Distress interaction to the prediction of attention and concentration scores after controlling for the effect of years of formal education. After controlling for the effect of years of formal education, pain severity and psychological distress did make separate and significant contributions to the prediction of memory scores; however, the Pain Severity x Psychological Distress interaction did not significantly affect memory scores. After controlling for the effect of years of formal education, there was no significant contribution of pain severity, psychological distress, or the Pain Severity x Psychological Distress interaction to reasoning ability scores. Results suggest the importance of assessing memory function when managing psychologically distressed chronic pain patients.

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Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims are associated with increased physical and psychological morbidity.

This study evaluated the separate and additive contributions of direct violent victimization, witnessed violence, and community chaos to children's posttraumatic stress reactions and behavior problems. Participants were 181 African American youths residing in low-income urban communities. Regression analyses revealed direct victimization to be most predictive of behavior problems and community chaos most predictive of posttraumatic stress reactions in children. Path models established community chaos as a mediator of the relation between witnessed violence and posttraumatic stress reactions and the relation between witnessed violence and behavior problems. Community chaos did not mediate the relation between direct victimization and posttraumatic stress reactions or behavior problems; however, a significant direct contribution of violent victimization to behavior problems was established. Findings support the emphasis placed on community chaos and instability in exacerbating stress reactions in the presence of interpersonal violence. Findings are discussed in terms of risk minimization and distress management.