Abstract
PurposeThe purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status.MethodParticipants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital.ResultsThe translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure.ConclusionConsistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.
Highlights
Chronic pain is often defined as any pain that lasts more than 3 months [1], and chronic pain of moderate to severe intensity occurs in 19% of adults in Europe [2]
Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for posttraumatic stress disorder (PTSD) according to a standardized self-report measure
The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted
Summary
Chronic pain is often defined as any pain that lasts more than 3 months [1], and chronic pain of moderate to severe intensity occurs in 19% of adults in Europe [2]. Individuals presenting for treatment of chronic pain often suffer from a range of comorbid conditions, including but not limited to anxiety and depression [3,4,5]. One such condition, underinvestigated in this population, is posttraumatic stress disorder (PTSD), which is defined by the presence of intrusions, avoidance, negative alterations in cognitions and mood, and hyperarousal and reactivity tied to the experience of a traumatic event [6]. The prevalence of PTSD in the general population has been estimated at approximately 6.8% lifetime and 3.5% in any 12month period [7, 8].
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