title: Sleep Quality and Reexperiencing Symptoms of PTSD Are Associated With Current Pain in U.S. OEF/OIF/OND Veterans With and Without mTBIs.
abstract: Pain, a debilitating condition, is frequently reported by U.S. veterans returning from Afghanistan and Iraq. This study investigated how commonly reported clinical factors were associated with pain and whether these associations differed for individuals with a history of chronic pain. From the Boston metropolitan area, 171 veterans enrolled in the Veterans Affairs Center of Excellence were assessed for current posttraumatic stress disorder (PTSD) symptom severity, current mood and anxiety diagnoses, lifetime traumatic brain injury, combat experiences, sleep quality, and alcohol use. Hierarchical regression models were used to determine the association of these conditions with current pain. Average pain for the previous 30 days, assessed with the McGill Pain Questionnaire, was 30.07 out of 100 (SD = 25.43). Sleep quality, PTSD symptom severity, and alcohol use were significantly associated with pain (R(2) = .24), as were reexperiencing symptoms of PTSD (R(2) = .25). For participants with a history of chronic pain (n = 65), only PTSD symptoms were associated with pain (R(2) = .19). Current pain severity was associated with increased PTSD severity (notably, reexperiencing symptoms), poor sleep quality, and increased alcohol use. These data support the hypothesis that PTSD symptoms influence pain, but suggest that problems with sleep and alcohol use may exacerbate the relationship.
authors.affiliation: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Powell
authors.affiliation: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Corbo
authors.affiliation: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Epidemiology, Boston University, Boston, Massachusetts, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Fonda
authors.affiliation: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University, Boston, Massachusetts, USA.|Department of Psychology, Boston University, Boston, Massachusetts, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Otis
authors.affiliation: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: William P
authors.initials: WP
authors.lastname: Milberg
authors.affiliation: Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Education and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Regina E
authors.initials: RE
authors.lastname: McGlinchey
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000428:Alcohol Drinking; D001008:Anxiety Disorders / Q000150:complications; D001930:Brain Injuries / Q000150:complications; D059350:Chronic Pain / Q000150:complications; D005107:Explosions; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications; D010146:Pain / Q000209:etiology*; D012044:Regression Analysis; D012720:Severity of Illness Index; D012890:Sleep; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology / Q000523:psychology*; D063189:Symptom Assessment; D014857:Warfare; D055815:Young Adult