Contributors to the Establishment, Maintenance, and Exacerbation of Comorbid Chronic Pain and Posttraumatic Stress Disorder
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Authors
Maunder, Larah
Date
Type
thesis
Language
eng
Keyword
Chronic pain , Posttraumatic stress disorder , Pain flashbacks , Interpretative phenomenological analysis , Pain-related disability , Sensitivity to pain traumatization , Pain catastrophizing
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Abstract
There is a high comorbidity between posttraumatic stress disorder (PTSD) and chronic pain, yet the factors that contribute to this relationship are not well understood. Research suggests that PTSD and chronic pain might interact and aggravate each other through common vulnerabilities and symptoms. To illuminate this interaction, this mixed methods dissertation examined the relationship between pain and PTSD symptoms in Canadian Armed Forces (CAF) service members and veterans. It also investigated the role that traumatic memory processes play in facilitating pain and PTSD by examining “pain flashbacks,” a symptom of PTSD in which individuals report re-experiencing pain they felt during a physically traumatic event. In Study 1, I investigated the factors that mediate the relationship between PTSD and pain-related disability in military personnel. Pain catastrophizing and pain traumatization sensitivity significantly mediated the relationship between PTSD and pain-related disability. In Study 2, I described how military personnel think about their experiences of PTSD and chronic pain to elucidate contributing factors to the comorbidity. I also described participants’ pain flashbacks to elucidate the role that they play in facilitating pain and PTSD. Three themes were identified from this qualitative analysis: “Ghost Pains,” “Traumatization from Within and Without,” and “Struggling Past the Traumatized Self.”
These studies add to our understanding of the establishment, maintenance, and exacerbation of comorbid chronic pain and PTSD, and contribute to knowledge of pain flashbacks. An understanding of this pain manifestation is critical, as pain flashbacks may magnify PTSD symptoms and worsen chronic pain severity, creating a downward spiral of mental and physical health symptoms. Furthermore, increased knowledge of pain flashbacks is important to our understanding of pain more generally, as the phenomenon suggests that the context in which we experience pain contributes to the encoding of memories of pain, and may facilitate the retrieval of memories of pain, or pain itself, when reminders of the encoding context arise later. By better understanding the contributing factors to chronic pain and PTSD, it may be possible to prevent the development or exacerbation of these conditions through early intervention and treatment strategies targeting the factors driving the conditions.
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Proquest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owne