Pain in the aftermath of trauma is a risk factor for post-traumatic stress disorder

• Published in: Psychological medicine Vol. 38; no. 4; pp. 533 - 542
• Main Authors: Norman, S. B., Stein, M. B., Dimsdale, J. E., Hoyt, D. B.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.04.2008
• Subjects: Acute stress disorder; Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Assaults; Biological and medical sciences; Child abuse & neglect; Early intervention; Female; Follow-Up Studies; Hospitalization; Humans; Male; Medical sciences; Middle Aged; Pain; Pain - psychology; Pain Measurement; Post traumatic stress disorder; Posttraumatic stress disorder; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; PTSD; Risk Factors; Sample size; Sex crimes; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Studies; trauma; Trauma centers; Traumatic stress; Wounds and Injuries - psychology; PTSD; trauma; risk factors; Pain; Posttraumatic syndrome; Anxiety disorder; Risk factor; Posttraumatic stress disorder; Trauma; Stress
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291707001389

Identifying risk factors for the development of post-traumatic stress disorder (PTSD) is important for understanding and ultimately preventing the disorder. This study assessed pain shortly after traumatic injury (i.e. peritraumatic pain) as a risk factor for PTSD. Participants (n=115) were patients admitted to a Level 1 Surgical Trauma Center. Admission to this service reflected a severe physical injury requiring specialized, emergent trauma care. Participants completed a pain questionnaire within 48 h of traumatic injury and a PTSD diagnostic module 4 and 8 months later. Peritraumatic pain was associated with an increased risk of PTSD, even after controlling for a number of other significant risk factors other than acute stress disorder symptoms. An increase of 0.5 s.d. from the mean in a 0-10 pain rating scale 24-48 h after injury was associated with an increased odds of PTSD at 4 months by more than fivefold, and at 8 months by almost sevenfold. A single item regarding amount of pain at the time of hospital admission correctly classified 65% of participants. If these findings are replicated in other samples, high levels of peritraumatic pain could be used to identify individuals at elevated risk for PTSD following traumatic injury.