Coping strategies and beliefs about pain in veterans with comorbid chronic pain and significant levels of posttraumatic stress disorder symptoms

Objectives: The purpose of this study was to assess differences in beliefs about pain and coping strategies employed in veterans with comorbid chronic pain and posttraumatic stress disorder (PTSD), compared to veterans with chronic pain alone. It was hypothesized that veterans with comorbid chronic pain and significant levels of PTSD symptomatology would report higher levels of maladaptive coping strategies and beliefs about pain when compared to veterans with pain alone. Methods: Data were obtained from 194 veterans who completed self-report questionnaires as part of their participation in a Psychology Pain Management Program at a northeastern Department of Veterans Affairs healthcare facility. Results: Analyses indicated that 47.4% of the sample scored above the clinical cutoff for PTSD symptomatology on the PTSD Checklist - Military Version (PCL-M). A Multivariate Analysis of Covariance (MANCOVA) was conducted with age and pain intensity as covariates. In support of the hypothesis, veterans with comorbid chronic pain and significant levels of PTSD symptomatology endorsed significantly higher levels of maladaptive coping strategies and beliefs about pain (greater catastrophizing and emotional impact on pain; less control over pain) when compared to veterans with chronic pain alone. Discussion: The results of this study suggest potential explanations for the previously observed negative effect of PTSD on chronic pain. Moreover, the results suggest specific targets for intervention with patients who have comorbid pain and PTSD.