Longitudinal Associations Among Pain, Posttraumatic Stress Disorder Symptoms, and Stress Appraisals.
Longitudinal Associations Among Pain, Posttraumatic Stress Disorder Symptoms, and Stress Appraisals.
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疼痛、创伤后应激障碍症状和压力评估之间的纵向关联。
DOI：
10.1002/jts.22083
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发表时间：
2016
影响因子：
3.3
通讯作者：
Meredith,LisaS
中科院分区：
文献类型：
--
作者：
Vaughan,ChristineA;Miles,JeremyNV;Eisenman,DavidP;Meredith,LisaS
创伤后应激障碍(PTSD)和疼痛的共病是有很好的文献记载的，但它们共病的机制还不是很清楚。用3波纵向数据对交叉滞后回归模型进行估计，以检验由临床医生管理的创伤后应激障碍量表(CAPS)衡量的创伤后应激障碍症状严重程度与由名为PEG(疼痛强度[P]、对生活享受的干扰[E]和对一般活动[G]的干扰)的简短的疼痛自我报告测量的疼痛之间的相互关联。我们在东北部大都市地区联邦合格卫生中心的低收入、服务不足的创伤后应激障碍(PTSD)患者(N=355)样本中，评估了压力评估作为这些关联的中介。在基线和6个月、6个月和12个月评估之间，创伤后应激障碍症状严重程度的增加是由更高的疼痛水平(两个滞后的β=0.14)和对生活压力的评估为不可控(两个滞后的β=0.15)独立预测的。然而，压力评估并没有调节这些联系，创伤后应激障碍症状的严重程度也不能预测疼痛的变化。因此，结果不支持压力评估作为疼痛和创伤后应激障碍之间联系的机制的作用。
Comorbidity of posttraumatic stress disorder (PTSD) and pain is well documented, but the mechanisms underlying their comorbidity are not well understood. Cross‐lagged regression models were estimated with 3 waves of longitudinal data to examine the reciprocal associations between PTSD symptom severity, as measured by the Clinician‐Administered PTSD Scale (CAPS), and pain, as measured by a brief self‐report measure of pain called the PEG (pain intensity [P], interference with enjoyment of life [E], and interference with general activity [G]). We evaluated stress appraisals as a mediator of these associations in a sample of low‐income, underserved patients with PTSD (N= 355) at federally qualified health centers in a northeastern metropolitan area. Increases in PTSD symptom severity between baseline and 6‐month and 6‐ and 12‐month assessments were independently predicted by higher levels of pain (β = .14 for both lags) and appraisals of life stress as uncontrollable (β = .15 for both lags). Stress appraisals, however, did not mediate these associations, and PTSD symptom severity did not predict change in pain. Thus, the results did not support the role of stress appraisals as a mechanism underlying the associations between pain and PTSD.