title: Symptoms of PTSD Associated With Painful and Nonpainful Vicarious Reactivity Following Amputation.
abstract: Although the experience of vicarious sensations when observing another in pain have been described postamputation, the underlying mechanisms are unknown. We investigated whether vicarious sensations are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. In Study 1, 236 amputees completed questionnaires about phantom limb phenomena and vicarious sensations to both innocuous and painful sensory experiences of others. There was a 10.2% incidence of vicarious sensations, which was significantly more prevalent in amputees reporting PTSD-like experiences, particularly increased arousal and reexperiencing the event that led to amputation (φ = .16). In Study 2, 63 amputees completed the Empathy for Pain Scale and PTSD Checklist-Civilian Version. Cluster analyses revealed 3 groups: 1 group did not experience vicarious pain or PTSD symptoms, and 2 groups were vicarious pain responders, but only 1 had increased PTSD symptoms. Only the latter group showed increased chronic pain severity compared with the nonresponder group (p = .025) with a moderate effect size (r = .35). The findings from both studies implicated an overlap, but also divergence, between PTSD symptoms and vicarious pain reactivity postamputation. Maladaptive mechanisms implicated in severe chronic pain and physical reactivity posttrauma may increase the incidence of vicarious reactivity to the pain of others.
authors.affiliation: School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.|Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.
authors.forename: Melita J
authors.initials: MJ
authors.lastname: Giummarra
authors.affiliation: Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, Victoria, Australia.
authors.forename: Bernadette M
authors.initials: BM
authors.lastname: Fitzgibbon
authors.affiliation: Departments of Neurology and Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Tsao
authors.affiliation: Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.|National Ageing Research Institute, Parkville, Victoria, Australia.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gibson
authors.affiliation: Department of Cognitive Science and ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Anina N
authors.initials: AN
authors.lastname: Rich
authors.affiliation: School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
authors.forename: Nellie
authors.initials: N
authors.lastname: Georgiou-Karistianis
authors.affiliation: Amputee Unit, Caulfield Hospital, Caulfield, Victoria, Australia.|Rehabilitation Services, Caulfield Hospital, Caulfield, Victoria, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Chou
authors.affiliation: Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Victoria, Australia.
authors.forename: John L
authors.initials: JL
authors.lastname: Bradshaw
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors.forename: Aimee L
authors.initials: AL
authors.lastname: Alphonso
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Tung
authors.affiliation: Pain Medicine Center, Naval Medical Center, San Diego, California, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Drastal
authors.affiliation: Pain Medicine Center, Naval Medical Center, San Diego, California, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Hanling
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Pasquina
authors.affiliation: Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, Victoria, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Enticott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects / Q000523:psychology*; D000674:Amputees / Q000523:psychology; D059350:Chronic Pain / Q000523:psychology; D000068376:Compassion Fatigue / Q000453:epidemiology* / Q000523:psychology; D004645:Empathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D010147:Pain Measurement; D010591:Phantom Limb / Q000209:etiology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012677:Sensation; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology