PTSD Symptoms and Acute Pain in the Emergency Department: The Roles of Vulnerability and Resilience Factors Among Low-income, Inner-city Women. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Lillis, Teresa A.; Burns, John; Aranda, Frances; Purim-Shem-Tov, Yanina A.; Bruehl, Stephen; Beckham, Jean C.; Hobfoll, Stevan E.
• Is Part Of: Clinical journal of pain. Volume 34:Issue 11(2018)
• Publication Date: 2018-11
• Subjects: COR theory -- PTSD symptoms -- acute pain -- vulnerability factors; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesia -- Periodicals; 616.047205
• DOI: 10.1097/AJP.0000000000000626
• Languages: English
• ISSNs: 0749-8047

Abstract

Abstract : Background: Given high levels of traumatic stress for low-income, inner-city women, investigating the link between posttraumatic stress disorder (PTSD) and pain is especially important. Purpose: Using the conservation of resources theory, we investigated direct and indirect relationships of PTSD symptoms, vulnerability factors (ie, resource loss, depressive symptoms, and social undermining), and resilience factors (ie, optimism, engagement, and social support) to acute pain reports in a sample of low-income, inner-city women. Methods: Participants (N=341; mean age=28 y; 58.0% African American) were recruited from an inner-city Emergency Department following presentation with acute pain. Study data were gathered from psychosocial questionnaires completed at a baseline interview. Results: Structural equation modeling examined direct and indirect relationships among PTSD symptoms, vulnerability factors, and resilience factors on self-reported pain intensity and pain interference. PTSD symptoms were directly related to higher pain intensity and pain interference and indirectly related through positive associations with vulnerability factors (all P s<0.05). Pathways through resilience factors were not supported. Conclusions: Results suggest that presence of PTSD symptoms is associated with elevated acute pain responses both indirectly via psychosocial vulnerability factors and directly, independent of the psychosocial factors assessed. Resilience factors did not play a significant role in determining acute pain responses. Consistent with conservation of resources theory, the negative effects of vulnerability factors outweighed the positive effects of resilience factors.