Treatment of Comorbid Pain and PTSD in Returning Veterans: A Collaborative Approach Utilizing Behavioral Activation

Plagge, Jane M.; Lu, Mary; Lovejoy, Travis I.; Karl, Andrea I.; Dobscha, Steven K.

doi:10.1111/pme.12155

Cited by 62 publications

(70 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings suggest that interventions that concurrently address chronic pain acceptance and these co-occurring conditions could be beneficial for reducing disability and improving quality of life. Combined interventions for PTSD and chronic pain have been developed, with preliminary empirical support (Bosco, Gallinati, & Clark, 2013; Otis, Keane, Kerns, Monson, & Scioli, 2009; Plagge, Lu, Lovejoy, Karl, & Dobscha, 2013). These treatments are primarily rooted in cognitive therapies (i.e., cognitive behavioral therapy, cognitive processing therapy), behavioral activation, and interdisciplinary treatment.…”

Section: Discussionmentioning

confidence: 99%

Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up

Cook

Meyer

Evans

et al. 2015

Behaviour Research and Therapy

View full text Add to dashboard Cite

War veterans are at increased risk for chronic pain and co-occurring neurobehavioral problems, including posttraumatic stress disorder (PTSD), depression, alcohol-related problems, and mild traumatic brain injury (mTBI). Each condition is associated with disability, particularly when co-occurring. Pain acceptance is a strong predictor of lower levels of disability in chronic pain. This study examined whether acceptance of pain predicted current and future disability beyond the effects of these co-occurring conditions in war veterans. Eighty trauma-exposed veterans with chronic pain completed a PTSD diagnostic interview, clinician-administered mTBI screening, and self-report measures of disability, pain acceptance, depression, and alcohol use. Hierarchical regression models showed pain acceptance to be incrementally associated with disability after accounting for symptoms of PTSD, depression, alcohol-related problems, and mTBI (total adjusted R2=.57, p<.001, ΔR2=.03, p=.02). At 1-year follow-up, the total variance in disability accounted for by the model decreased (total adjusted R2 =.29, p<.001), whereas the unique contribution of pain acceptance increased (ΔR2=.07, p=.008). Pain acceptance remained significantly associated with 1-year disability when pain severity was included in the model. Future research should evaluate treatments that address chronic pain acceptance and co-occurring conditions to promote functional recovery in the context of polytrauma in war veterans.

show abstract

Section: Discussionmentioning

confidence: 99%

Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up

Cook

Meyer

Evans

et al. 2015

Behaviour Research and Therapy

View full text Add to dashboard Cite

show abstract

“…Adult guidelines recommend treating overlapping pain and PTSD symptoms (e.g., fears and avoidance behaviors) concurrently [9,187]. Dually targeted interventions have been developed for adults that combine PTSD behavioral activation, pain education and emphasis on exercise [9,188]. Similarly, other programs developed for adult veterans have combined cognitive processing therapy for PTSD with CBT for chronic pain [9,189].…”

Section: Treatments For Comorbid Chronic Pain In Youthmentioning

confidence: 99%

Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment

et al. 2016

View full text Add to dashboard Cite

Chronic pain during childhood and adolescence can lead to persistent pain problems and mental health disorders into adulthood. Posttraumatic stress disorders and depressive and anxiety disorders are mental health conditions that co-occur at high rates in both adolescent and adult samples, and are linked to heightened impairment and disability. Comorbid chronic pain and psychopathology has been explained by the presence of shared neurobiology and mutually maintaining cognitive-affective and behavioral factors that lead to the development and/or maintenance of both conditions. Particularly within the pediatric chronic pain population, these factors are embedded within the broader context of the parent–child relationship. In this review, we will explore the epidemiology of, and current working models explaining, these comorbidities. Particular emphasis will be made on shared neurobiological mechanisms, given that the majority of previous research to date has centered on cognitive, affective, and behavioral mechanisms. Parental contributions to co-occurring chronic pain and psychopathology in childhood and adolescence will be discussed. Moreover, we will review current treatment recommendations and future directions for both research and practice. We argue that the integration of biological and behavioral approaches will be critical to sufficiently address why these comorbidities exist and how they can best be targeted in treatment.

show abstract

“…Plagge et al [ 112 ] reported an uncontrolled, retrospective study of 58 US veterans with various chronic pain conditions and PTSD (or signifi cant PTSD symptoms) who were enrolled in an 8-session behavioral activation intervention. Mean duration of chronic pain and PTSD was 7.2 and 5.6 years, respectively.…”

Section: Psychological Treatment Of Comorbid Ptsd and Chronic Painmentioning

confidence: 99%

Chronic Pain and the Anxiety Disorders: Epidemiology, Mechanisms and Models of Comorbidity, and Treatment

Katz

Pagé

Fashler

et al. 2014

Mental Health and Pain

View full text Add to dashboard Cite

Chronic pain was traditionally defi ned by the length of time that pain persists [ 54 ] but more recent conceptualizations have introduced a more nuanced approach [ 85 ]. The International Association for the Study of Pain (IASP) currently defi nes chronic pain variously as " pain without apparent biological value ", " that has persisted beyond the normal tissue healing time … as determined by common medical experience ", and/or as " a persistent pain that is not amenable, as a rule, to treatments based upon specifi c remedies " [ 85 ]. Moreover, some chronic pain syndromes, such as rheumatoid arthritis, will likely never heal and others, such as migraine headaches, remit (i.e., heal) and then recur [ 85 ]. Notwithstanding the challenges associated with defi ning chronic pain and the problems with a solely, time-based defi nition, for research purposes, chronic non-malignant pain is typically defi ned as pain that persists for longer than 3 or 6 months [ 58 , 59 , 74 , 126 ].Recent epidemiologic studies reveal considerable variability in prevalence estimates for chronic pain (using a liberal time frame of 3 months or longer). These studies show that between 11.5 and 55 % of the population worldwide report chronic

show abstract

Treatment of Comorbid Pain and PTSD in Returning Veterans: A Collaborative Approach Utilizing Behavioral Activation

Abstract: These findings suggest that a collaborative approach that includes BA is feasible and a potentially effective treatment for comorbid chronic pain and PTSD.

Cited by 62 publications

References 43 publications

Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up

Chronic pain acceptance incrementally predicts disability in polytrauma-exposed veterans at baseline and 1-year follow-up

Mental Health Comorbidities in Pediatric Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological Mechanisms and Treatment

Chronic Pain and the Anxiety Disorders: Epidemiology, Mechanisms and Models of Comorbidity, and Treatment

Contact Info

Product

Resources

About