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Citation |
Defrin R, Lahav Y, Solomon Z. J. Pain 2016; 18(1): 1-10. |
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Affiliation |
Bob Shapell School of Social work, Tel-Aviv University, Israel. |
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Copyright |
(Copyright © 2016, Elsevier Publishing) |
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DOI |
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PMID |
27687222 |
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Abstract |
Trauma survivors, and particularly torture survivors, suffer from high rates of chronic pain and posttraumatic stress disorder (PTSD) for years afterwards, along with alterations in the function of the pain system. Based on longitudinal data on PTSD symptomatology, we tested whether exposure to torture, PTSD or PTSD trajectories accounted for chronic pain and altered pain perception. PARTICIPANTS: were 59 torture survivors and 44 age-matched healthy controls (HC). Chronic pain was characterized. Pain threshold, pain tolerance, conditioned pain modulation (CPM) and temporal summation of pain (TSP) were measured. Three PTSD trajectories were identified among torture survivors; chronic, delayed and resilient. Lack of CPM and more intense chronic pain was found among the chronic and delayed groups compared to resilient and HC. TSP was strongest among the chronic group. PTSD trajectories mediated the relationship between torture and CPM. It appears that the duration and severity of posttraumatic distress, rather than the exposure to trauma, are crucial factors that mediate the association between trauma and chronic pain. Since PTSD and its resultant distress are measurable, their evaluation seems particularly important in the management of pain among trauma survivors. The results may be generalized to other instances where chronic pain persists after traumatic events. PERSPECTIVES: This article presents the mediation effect of PTSD trajectory on pain modulation among trauma survivors suggesting that it is the duration and severity of PTSD/distress, rather than the exposure to trauma per se, that influence the perception and modulation of pain. Language: en |