The Effects of Chronic Pain as Continuous Traumatic Stressors

Background: The study aims to provide empirical evidence that Chronic Pain (CP) is an independent continuous traumatic stressor that yields symptoms of Peri-Continuous Traumatic Stress Syndrome (PCTSS) that include symptoms of PTSD, depression, anxiety, pathological dissociation, somatization, executive function deficits, and disability that warrant significant mental health treatment. Methods: In a sample of 211 chronic pain adult patients, 75.4% were female, aged 18 to 65. We measured CP, all the components of PCTSS, and cumulative stressors and traumas. We conducted Hierarchical Multiple Regression (HMR) and Structural Equation Modeling (SEM). In the HMR analyses, the dependent variables were the PCTSS components; in each analysis, in the first step, we entered demographics, cumulative stressors, and traumas in the second step and chronic pain in the last step as the independent variables. In the SEM analysis, chronic pain predicted the latent variables of mental health and executive function deficits, as well as the observed variable of disability. Results: The results of HMR and SEM found that CP accounted for a significant independent variance for each PCTSS component above and beyond all other cumulative stressors and trauma contributions. Conclusions: This is the first study that provides evidence that chronic pain is an independent predictor of PTSD and other PCTSS syndrome components. The conceptual implications of shifting the paradigm we used to frame chronic pain as an independent variable that yields PCTSS syndrome, and the clinical implication for the importance of psychological treatment of chronic pain, especially to reduce the pain drug-overdose suicide epidemic, are discussed.