Interaction of posttraumatic stress disorder and chronic pain following traumatic brain injury.
OBJECTIVE
To investigate the association between posttraumatic stress disorder (PTSD) and chronic pain in patients who had sustained a severe traumatic brain injury (TBI).


METHODS
Correlational relationships between pain variables and PTSD measures were examined in a cohort study.


METHODS
An adult tertiary care center brain injury clinic.


METHODS
Ninety-six persons with severe TBI.


METHODS
The Posttraumatic Stress Disorder Interview (PTSD-I), a modified McGill Pain Questionnaire, the Beck Depression Inventory (BDI), the General Health Questionnaire (GHQ), the Community Integration Questionnaire (CIQ), the Satisfaction with Life Scale (SWL), and the Coping Style Questionnaire (CSQ).


RESULTS
More persons with chronic pain reported PTSD than did those without pain. The relationship between pain severity and depression, functional adjustment, and satisfaction with life was mediated by severity of PTSD. Pain severity was significantly associated with an avoidant coping style.


CONCLUSIONS
Effective rehabilitation of persons with chronic pain following severe TBI should recognize the role of posttraumatic stress in the maintenance of dysfunctional reactions. Specific interventions that address adaptive coping mechanisms to reduce PTSD may enhance rehabilitation for persons with TBI who suffer chronic pain.
Bryant
R A
RA
School of Psychology, University of New South Wales, New South Wales, Australia. r.bryant@unsw.edu.au
Marosszeky
J E
JE
Crooks
J
J
Baguley
I J
IJ
Gurka
J A
JA
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications*; D002908:Chronic Disease; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010147:Pain Measurement; D010549:Personal Satisfaction; D011788:Quality of Life; D012917:Social Adjustment; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*