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Posttraumatic stress symptoms and the diathesis-stress model of chronic pain and disability in patients undergoing major surgery.
Clin J Pain. 2010 Jul-Aug; 26(6):518-27.CJ

Abstract

OBJECTIVES

To (1) use structural equation modeling (SEM) to examine relationships proposed in Turk's diathesis-stress model of chronic pain and disability as well as (2) investigate what role, if any, posttraumatic stress symptoms (PTSS) play in predicting pain disability, relative to some of the other factors in the model.

METHODS

The study sample consisted of 208 patients scheduled for general surgery, 21 to 60 years of age (mean age=47.18 y, SD=9.72 y), who reported experiencing persistent pain for an average of 5.56 years (SD=7.90 y). At their preadmission hospital visit, patients completed the Anxiety Sensitivity Index, Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale-20, Pain Disability Index, posttraumatic stress disorder Checklist, and rated the average intensity of their pain (0 to 10 numeric rating scale). SEM was used to test a model of chronic pain disability and to explore potential relationships between PTSS and factors in the diathesis-stress model.

RESULTS

SEM results provided support for a model in which anxiety sensitivity predicted fear of pain and catastrophizing, fear of pain predicted escape/avoidance, and escape/avoidance predicted pain disability. Results also provided support for a feedback loop between disability and fear of pain. SEM analyses provided preliminary support for the inclusion of PTSS in the diathesis-stress model, with PTSS accounting for a significant proportion of the variance in pain disability.

DISCUSSION

Results provide empirical support for aspects of Turk's diathesis-stress model in a sample of patients with persistent pain. Findings also offer preliminary support for the role of PTSS in fear-avoidance models of chronic pain.

Authors+Show Affiliations

Department of Psychology, York University, Toronto, Ontario, Canada. jkatz@yorku.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20551727

Citation

Martin, Andrea L., et al. "Posttraumatic Stress Symptoms and the Diathesis-stress Model of Chronic Pain and Disability in Patients Undergoing Major Surgery." The Clinical Journal of Pain, vol. 26, no. 6, 2010, pp. 518-27.
Martin AL, Halket E, Asmundson GJ, et al. Posttraumatic stress symptoms and the diathesis-stress model of chronic pain and disability in patients undergoing major surgery. Clin J Pain. 2010;26(6):518-27.
Martin, A. L., Halket, E., Asmundson, G. J., Flora, D. B., & Katz, J. (2010). Posttraumatic stress symptoms and the diathesis-stress model of chronic pain and disability in patients undergoing major surgery. The Clinical Journal of Pain, 26(6), 518-27. https://doi.org/10.1097/AJP.0b013e3181e15b98
Martin AL, et al. Posttraumatic Stress Symptoms and the Diathesis-stress Model of Chronic Pain and Disability in Patients Undergoing Major Surgery. Clin J Pain. 2010 Jul-Aug;26(6):518-27. PubMed PMID: 20551727.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posttraumatic stress symptoms and the diathesis-stress model of chronic pain and disability in patients undergoing major surgery. AU - Martin,Andrea L, AU - Halket,Eileen, AU - Asmundson,Gordon J G, AU - Flora,David B, AU - Katz,Joel, PY - 2010/6/17/entrez PY - 2010/6/17/pubmed PY - 2010/9/24/medline SP - 518 EP - 27 JF - The Clinical journal of pain JO - Clin J Pain VL - 26 IS - 6 N2 - OBJECTIVES: To (1) use structural equation modeling (SEM) to examine relationships proposed in Turk's diathesis-stress model of chronic pain and disability as well as (2) investigate what role, if any, posttraumatic stress symptoms (PTSS) play in predicting pain disability, relative to some of the other factors in the model. METHODS: The study sample consisted of 208 patients scheduled for general surgery, 21 to 60 years of age (mean age=47.18 y, SD=9.72 y), who reported experiencing persistent pain for an average of 5.56 years (SD=7.90 y). At their preadmission hospital visit, patients completed the Anxiety Sensitivity Index, Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale-20, Pain Disability Index, posttraumatic stress disorder Checklist, and rated the average intensity of their pain (0 to 10 numeric rating scale). SEM was used to test a model of chronic pain disability and to explore potential relationships between PTSS and factors in the diathesis-stress model. RESULTS: SEM results provided support for a model in which anxiety sensitivity predicted fear of pain and catastrophizing, fear of pain predicted escape/avoidance, and escape/avoidance predicted pain disability. Results also provided support for a feedback loop between disability and fear of pain. SEM analyses provided preliminary support for the inclusion of PTSS in the diathesis-stress model, with PTSS accounting for a significant proportion of the variance in pain disability. DISCUSSION: Results provide empirical support for aspects of Turk's diathesis-stress model in a sample of patients with persistent pain. Findings also offer preliminary support for the role of PTSS in fear-avoidance models of chronic pain. SN - 1536-5409 UR - https://www.unboundmedicine.com/medline/citation/20551727/Posttraumatic_stress_symptoms_and_the_diathesis_stress_model_of_chronic_pain_and_disability_in_patients_undergoing_major_surgery_ L2 - https://doi.org/10.1097/AJP.0b013e3181e15b98 DB - PRIME DP - Unbound Medicine ER -