Pain interference and quality of life in combat veterans: Examining the roles of posttraumatic stress disorder, traumatic brain injury, and sleep quality.

Abstract

Objective: The goal of this study was to examine the associations among posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), sleep quality, pain interference, and quality of life in combat veterans. Method: Veterans (N ϭ 289, 86.51% male) completed the Mid-Atlantic MIRECC Assessment of Traumatic Brain Injury, the Clinician-Administered PTSD Scale for DSM-5, and measures of sleep quality, pain interference, and quality of life. Results: Hierarchical linear regressions evaluated associations between PTSD severity, deployment TBI severity, sleep quality, and the outcomes of pain interference and quality of life after adjusting for demographic variables and the number of nondeployment TBIs. PTSD severity, B ϭ 0.15, SE B ϭ 0.04, deployment TBI severity, B ϭ 3.98, SE B ϭ 1.01, and sleep quality, B ϭ 0.74, SE B ϭ 0.13, were significantly associated with pain interference, p Ͻ .001. PTSD severity, B ϭ Ϫ0.57, SE B ϭ 0.07, and pain interference, B ϭ Ϫ0.45, SE B ϭ 0.11, were significantly, independently associated with quality of life, p Ͻ .001. However, pain interference, B ϭ Ϫ0.24, SE B ϭ 0.11, was no longer significantly associated with quality of life when sleep quality, B ϭ Ϫ1.56, SE B ϭ 0.25, was included in the model. There was no significant association between deployment TBI severity and quality of life. Interactions among the studied variables were not significant for either of the outcome variables. Conclusions: PTSD symptom severity, deployment TBI history, and sleep quality may be important to consider in treatment planning for veterans experiencing pain-related functional interference. For veterans with numerous conditions comorbid with pain, treatment plans may include interventions targeting sleep and PTSD to maximize quality of life improvements.

Common Symptoms of Mild Traumatic Brain Injury and Work Functioning of Active-Duty Service Members with a History of Deployment

“…Because ADSMs are always screened for mTBI as well as these symptoms before and after any deployment, we are confident that the symptoms are a sequalae of mTBI and not pre-existing conditions. Further, these findings are consistent with other studies that have investigated the association between TBI and other employment-related outcomes [14,29,33,[39][40][41][42][43][44][45][46][47].…”

Factors associated with recovery from posttraumatic stress disorder in combat veterans: The role of deployment mild traumatic brain injury (mTBI).

“…The investigators concluded that sleep-focused treatments may be an effective way to facilitate psychiatric recovery (Rusch et al, 2015). Similarly, Ord et al (2021) demonstrated that sleep was significantly associated with quality of life beyond symptoms of PTSD and deployment TBI history in post-9/11 veterans and suggested that behavioral sleep treatments may be beneficial as an adjunct or first-line treatment for veterans with PTSD and/or TBI history. Taken as a whole, results of the present study and extant research underscore the importance of comprehensive rehabilitation approaches when treating individuals with PTSD.…”

Comprehensive Caregiver Supports and Ascertainment and Treatment of Veteran Pain

“…At the time of application to PCAFC, over 60% of applicants had a musculoskeletal disorder and nearly half had a pain code of some type (Van Houtven, Smith, Stechuchak, et al, 2019). It is vital to identify and treat pain for these Veterans due to the quality of life reductions that arise for those experiencing chronic pain and the associated debilitating comorbidities that commonly occur with chronic pain, including depression and substance use (Kerns & Dobscha, 2009; Murphy et al, 2022; Naylor et al, 2019; Ord et al, 2021; Saconi et al, 2023). To date, we know surprisingly little about how services and supports to family caregivers affect care recipient health and well-being (Coe et al, 2021).…”