The role of pain and socioenvironmental factors on posttraumatic stress disorder symptoms in traumatically injured adults: A 1‐year prospective study

Abstract

Approximately 20% of individuals who experience a traumatic injury will subsequently develop posttraumatic stress disorder (PTSD). Physical pain following traumatic injury has received increasing attention as both a distinct, functionally debilitating disorder and a comorbid symptom related to PTSD. Studies have demonstrated that both clinician‐assessed injury severity and patient pain ratings can be important predictors of nonremitting PTSD; however, few have examined pain and PTSD alongside socioenvironmental factors. We postulated that both area‐ and individual‐level socioeconomic circumstances and lifetime trauma history would be uniquely associated with PTSD symptoms and interact with the pain–PTSD association. To test these effects, pain and PTSD symptoms were assessed at four visits across a 1‐year period in a sample of 219 traumatically injured participants recruited from a Level 1 trauma center. We used a hierarchal linear modeling approach to evaluate whether (a) patient‐reported pain ratings were a better predictor of PTSD than clinician‐assessed injury severity scores and (b) socioenvironmental factors, specifically neighborhood socioeconomic disadvantage, individual income, and lifetime trauma history, influenced the pain–PTSD association. Results demonstrated associations between patient‐reported pain ratings, but not clinician‐assessed injury severity scores, and PTSD symptoms, R2(fvm) = .65. There was a significant interaction between neighborhood socioeconomic disadvantage and pain such that higher disadvantage decreased the strength of the pain–PTSD association but only among White participants, R2(fvm) = .69. Future directions include testing this question in a larger, more diverse sample of trauma survivors (e.g., geographically diverse) and examining factors that may alleviate both pain and PTSD symptoms.

Psychometric Properties of the Arabic Translation of the Physical Appearance Comparison Scale- Revised (PACS-R) in Adults

“…Social comparison and more speci cally appearance comparison are associated with body dissatisfaction, disordered eating, and low self-esteem [14,23] . Social comparison correlates positively with psychological distress [24] , depression and anxiety [25] . Furthermore, physical comparison was seen to be associated with higher anxiety [23,26] and depression [27] .…”

Neighborhood poverty prospectively predicts PTSD symptoms six‐months following trauma exposure

“…One prospective study did not find a direct relationship between neighborhood deprivation and future PTSD symptoms, though the authors suggest the study was underpowered to detect such an effect (Webb et al, 2022). To the best of our knowledge, this study by Webb and colleagues (Webb et al, 2022) is the only longitudinal study assessing the role of neighborhood context on future PTSD symptoms. In the current prospective study, we aimed to add to the literature on the relationships between neighborhood context and future PTSD symptoms.…”

“…Prospective studies immediately following trauma exposure are critical to understand better the development of PTSD and can help determine individuals who might benefit from early intervention, such as prolonged exposure (Rothbaum et al, 2014). One prospective study did not find a direct relationship between neighborhood deprivation and future PTSD symptoms, though the authors suggest the study was underpowered to detect such an effect (Webb et al, 2022). To the best of our knowledge, this study by Webb and colleagues (Webb et al, 2022) is the only longitudinal study assessing the role of neighborhood context on future PTSD symptoms.…”