Chronic posttraumatic stress disorder and chronic pain in Vietnam combat veterans

Beckham, Jean C.; Crawford, Angela L.; Feldman, Michelle E.; Kirby, Angela C.; Hertzberg, Michael A.; Davidson, Jonathan; Moore, Scott D.

doi:10.1016/s0022-3999(97)00129-3

Cited by 250 publications

(184 citation statements)

References 37 publications

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“…The high rate of comorbidity between chronic pain and PTSD has been well documented [5,9,[42][43][44], and results from this study are consistent with these prior epidemiologic studies that have identified high prevalence rates of chronic pain and PTSD. Previous literature has demonstrated associations between PTSD and intensified pain severity, disability, and interference [45][46][47]; however, at least one study did not corroborate this finding [4].…”

Section: Outcalt Et Al Veterans With Comorbid Chronic Pain and Ptsdsupporting

confidence: 89%

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Outcalt

Ang

et al. 2014

J Rehabil Res Dev

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Abstract-Chronic pain and posttraumatic stress disorder (PTSD) co-occur at high rates, and Veterans from recent wars in Iraq and Afghanistan may be particularly vulnerable to both conditions. The objective of this study was to identify key aspects of chronic pain, cognitions, and psychological distress associated with comorbid PTSD among this sample of Veterans. Baseline data were analyzed from a randomized controlled trial testing a stepped-care intervention for chronic musculoskeletal pain. Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans with chronic pain only (n = 173) were compared with those with chronic pain and clinically significant posttraumatic stress symptoms (n = 68). Group differences on pain characteristics, pain cognitions, and psychological distress were evaluated. Results demonstrated that OIF/OEF Veterans with comorbid chronic musculoskeletal pain and PTSD experienced higher pain severity, greater painrelated disability and increased pain interference, more maladaptive pain cognitions (e.g., catastrophizing, self-efficacy, pain centrality), and higher affective distress than those with chronic pain alone. Veterans of recent military conflicts in Iraq and Afghanistan may be particularly vulnerable to the compounded adverse effects of chronic pain and PTSD. These results highlight a more intense and disabling pain and psychological experience for those with chronic pain and PTSD than for those without PTSD. Clinical

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Section: Outcalt Et Al Veterans With Comorbid Chronic Pain and Ptsdsupporting

confidence: 89%

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Outcalt

Ang

et al. 2014

J Rehabil Res Dev

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show abstract

“…An average of 65% of patients with major depression have some degree of comorbid pain symptoms (Bair et al, 2003). Similarly, 20-30% of outpatient civilian samples with PTSD (Hubbard et al, 1995;Amir et al, 1997;Beckham et al, 1997) and 80% of combat veterans with PTSD (Beckham et al, 1997) have comorbid chronic pain. If there is also an association between pain and CSF CRF in these populations, this could account for some of the previously inconsistent results of studies examining CSF CRF concentration in these disorders.…”

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid Corticotropin-Releasing Factor Concentration is Associated with Pain but not Fatigue Symptoms in Patients with Fibromyalgia

McLean

Williams

Stein

et al. 2006

Neuropsychopharmacol

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Previous studies have identified stress system dysregulation in fibromyalgia (FM) patients; such dysregulation may be involved in the generation and/or maintenance of pain and other symptoms. Corticotropin-releasing factor (CRF) is the principal known central nervous system mediator of the stress response; however, to date no studies have examined cerebrospinal fluid (CSF) CRF levels in patients with FM. The relationship between CSF CRF level, heart rate variability (HRV), and pain, fatigue, and depressive symptoms was examined in patients with FM. Among participants (n ¼ 26), CSF CRF levels were associated with sensory pain symptoms (r ¼ 0.574, p ¼ 0.003) and affective pain symptoms (r ¼ 0.497, p ¼ 0.011), but not fatigue symptoms. Increased HRV was also strongly associated with increased CSF CRF and FM pain. In multivariate analyses adjusting for age, sex, and depressive symptoms, the association between CSF CRF and sensory pain symptoms (t ¼ 2.54, p ¼ 0.027) persisted. Women with FM who reported a history of physical or sexual abuse had lower CSF CRF levels than women who did not report such a history. CSF CRF levels are associated with both pain symptoms and variation in autonomic function in FM. Differences in CSF CRF levels among women with and without a self-reported history of physical or sexual abuse suggest that subgroups of FM patients may exist with different neurobiological characteristics. Further studies are needed to better understand the nature of the association between CSF CRF and pain symptoms in FM.

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“…However, reporting of previous pain is known to be distorted in chronic pain patients (Bryant, 1993;Eich et al, 1985). Other studies have shown that both clinical and experimental pain enhance recall of aversive words in a memory task (Pearce et al, 1990;Seltzer and Yarczower, 1991), and increased pain levels are associated with increased re-experiencing symptoms in post-traumatic stress disorder (Beckham et al, 1997), suggesting that pain may actually enhance aversive memory. In animal models of pain, cognitive impairments have been demonstrated in novel-object exploration, operant learning tasks and the Morris Water Maze tests of spatial learning and memory (BoyetteDavis et al, 2008;Hu et al, 2010;Leite-Almeida et al, 2009;Millecamps et al, 2004;Pais-Vieira et al, 2009a).…”

Section: Introductionmentioning

confidence: 99%

Validation of an air-puff passive-avoidance paradigm for assessment of aversive learning and memory in rat models of chronic pain

Moriarty

Roche

McGuire

et al. 2012

Journal of Neuroscience Methods

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Chronic posttraumatic stress disorder and chronic pain in Vietnam combat veterans

Cited by 250 publications

References 37 publications

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Pain experience of Iraq and Afghanistan Veterans with comorbid chronic pain and posttraumatic stress

Cerebrospinal Fluid Corticotropin-Releasing Factor Concentration is Associated with Pain but not Fatigue Symptoms in Patients with Fibromyalgia

Validation of an air-puff passive-avoidance paradigm for assessment of aversive learning and memory in rat models of chronic pain

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