Poster Abstracts
Zona Iftikhar, BSc (Hons)
Research Assistant
University of Regina
Regina, Saskatchewan, Canada
Recent research has found that chronic pain and post-traumatic stress disorder (PTSD) often co-occur. This link is essential in pain management due to the complex nature of pain and the role psychological disorders play in the prevalence and severity of pain. In fact, individuals with comorbid pain and PTSD tend to report more health problems, more pain-related disability, higher pain ratings, and increased functional impairment. Psychological interventions are considered effective individually for reducing pain-related and trauma-related symptoms; however, less is known about their effectiveness to reduce symptoms of post-traumatic stress and pain simultaneously. To better understand, we reviewed the current literature on treatments for co-morbid chronic pain and PTSD.
Purpose/Objectives: This study was a scoping review of the current literature on evidence-based psychological interventions for individuals living with chronic pain and post-traumatic stress disorder or trauma-related symptoms. Upon completion, we will be able to identify, describe, and compare various pain management treatments, strategies, and skills within the domain of psychology.
Method:
To conduct the scoping review, PsycINFO and Web of Science, were used to identify relevant articles using the search terms relevant “adults, chronic pain, post-traumatic stress disorder, and trauma.” Original randomized clinical trials (RCT) and nonrandomized trials were included. Studies with participants above the age of 18 living with chronic pain and with experiences of trauma or post-traumatic stress disorder were included. Case reports, review articles, and meta-analyses were excluded.
To organize and manage the data, we extracted study characteristics and main findings from the articles. Specifically, we extracted information on author(s), year of publication, objectives, context, population (e.g., age and/or sex), measures for pain and trauma, interventions, outcomes, and future directions.
Results:
Our search yielded 1192 articles (409 PsychINFO and 783 Web of Science) with 132 duplicates, resulting in 1060 articles that were subjected to title and abstract review. Of those, 896 were excluded, leaving 164 articles for full-text review. One hundred and twenty-two articles were excluded after a full-text review. A total of 32 articles met the inclusion criteria and were included in the study. Eligible studies included interventions, such as cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), eye movement desensitization reprocessing (EMDR), and psychoeducation to treat chronic pain intensity and interference along with trauma-related symptoms in a variety of populations (e.g., veterans, refugees, patients).
Conclusions: This study revealed that current evidence-based research in the field of pain and trauma management focuses on reducing the frequency and intensity of pain-related and trauma-related symptoms through a series of mechanisms, such as exposure, mindfulness, compassion, and cognitive restructuring. These findings are important as they outline effective psychological strategies and skills for healthcare professionals to utilize in pain management. Based on the findings of this review, future original studies on chronic pain and PTSD should focus on (1) larger and more diverse samples of individuals living with co-morbid chronic pain and PTSD; (2) assess the clinical utility, acceptability and feasibility of the interventions in a randomized controlled trial; and (3) examine long-term effects of participation in each intervention. Reviews using more comprehensive search and evaluation methodologies that include studies published in other languages other than English are also warranted.
References: [1] Bosco, M. A., Gallinati, J. L., & Clark, M. E. (2013). Conceptualizing and treating comorbid chronic pain and PTSD. Pain research and treatment, 2013.
[2] Kind, S., & Otis, J. D. (2019). The interaction between chronic pain and PTSD. Current pain and headache reports, 23, 1-7.
[3] Lumley, M. A., Yamin, J. B., Pester, B. D., Krohner, S., & Urbanik, C. P. (2022). Trauma matters: psychological interventions for comorbid psychosocial trauma and chronic pain. Pain, 163(4), 599-603.