Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms

Liedl, Alexandra; O’Donnell, Meaghan; Creamer, Mark; Silove, Derrick; McFarlane, Alexander C.; Knaevelsrud, Christine; Bryant, Richard A.

doi:10.1017/s0033291709991310

Cited by 117 publications

(144 citation statements)

References 51 publications

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“…According to this model, persons with PTSD experience exacerbating pain because they use avoidance as a coping strategy, have reduced activity levels, and attentional biases towards perceiving stimuli as implying danger. This model has received some empirical support among injured patients (Jenewein et al, 2009; Liedl et al, 2010) and in persons exposed to childhood abuse (Raphael, Spatz, & Widom, 2011). …”

Section: Discussionmentioning

confidence: 99%

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Siqveland

Ruud

Hauff

2017

European Journal of Psychotraumatology

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Background: Trauma exposure and post-traumatic stress disorder (PTSD) are risk factors for chronic pain. Objective: This study investigated how exposure to intentional and non-intentional traumatic events and PTSD are related to pain severity and outcome of treatment in chronic pain patients. Methods: We assessed exposure to potentially traumatizing events, psychiatric diagnosis with structured clinical interview, and pain severity in 63 patients at a secondary multidisciplinary pain clinic at the beginning of treatment, and assessed level of pain at follow up. Exposure to potentially traumatizing events and PTSD were regressed on pain severity at the initial session and at follow up in a set of multiple regression analysis. Results: The participants reported exposure to an average of four potentially traumatizing events, and 32% had PTSD. Exposure to intentional traumatic events and PTSD were significantly associated with more severe pain, and PTSD significantly moderated the relationship between trauma exposure and pain (all p < .05). The treatment programme reduced pain moderately, an effect that was unrelated to trauma exposure and PTSD. Conclusions: Trauma exposure is related to chronic pain in the same pattern as to mental disorders, with intentional trauma being most strongly related to pain severity. PTSD moderated the relationship between trauma exposure and pain. While pain patients with PTSD initially report more pain, they responded equally to specialist pain treatment as persons without PTSD.

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Section: Discussionmentioning

confidence: 99%

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Siqveland

Ruud

Hauff

2017

European Journal of Psychotraumatology

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“…Carleton et al (2009) found chronic pain comorbid with generalized anxiety disorder. Liedl et al (2010) provided evidence for the mutual maintenance of pain and symptoms of PTSD, consistent with the model of Sharp and Harvey (2001). Sharp and Harvey (2001) had argued that patients with PTSD consider their pain experience as a constant reminder of the triggering event.…”

Section: Painmentioning

confidence: 58%

“…Sharp and Harvey (2001) had argued that patients with PTSD consider their pain experience as a constant reminder of the triggering event. In this regard, Liedl et al (2010) found that baseline posttraumatic re-experiencing symptoms were related to the same symptoms at 12 months; moreover, they were mediated by levels of pain at 3 months. Another relevant model is that of Liedl and Knaevelsrud (2008).…”

Section: Painmentioning

confidence: 86%

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Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

Young

2010

Psychol. Inj. and Law

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This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing commentary for practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.

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“…The difficulty in treating polytrauma obtains because of mutual maintenance factors (e.g., Liedl et al 2010, for pain and PTSD). Vicious circles develop that exacerbate reciprocally the conditions, e.g., through hyperarousal and hypersensitization (McFarlane 2010).…”

Section: Treatmentmentioning

confidence: 99%

Erratum to: Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

Young

2011

Psychol. Inj. and Law

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This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing practice in the area. The field is a fastdeveloping one, with over ten major topics that it needs to integrate. In particular, the present review focuses on current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.

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Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms

Abstract: These findings provide evidence of mutual maintenance between pain and PTSD.

Cited by 117 publications

References 51 publications

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

Erratum to: Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

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