Pain sensitivity in posttraumatic stress disorder and other anxiety disorders: a preliminary case control study
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PRIMARY RESEARCH
Open Access
Pain sensitivity in posttraumatic stress disorder and other anxiety disorders: a preliminary case control study Sheeva Mostoufi1,2, Kathryn M Godfrey1,2, Sandra M Ahumada3, Nazia Hossain2, Titus Song4, Lisa Johnson Wright5, James B Lohr2,4 and Niloofar Afari2,4*
Abstract Background: Despite substantial research on the comorbidity of anxiety disorders including posttraumatic stress disorder (PTSD) and chronic pain, little is known about the mechanisms underlying these conditions that might be potentially similar. Evoked pain sensitivity is one factor that has been associated with several pain conditions which might also have relevance to anxiety disorders and PTSD. The aim of this preliminary study was to examine evoked pain sensitivity in PTSD compared to other anxiety disorders and in control participants. Method: The study used a cross-sectional case-control design in which participants completed a battery of questionnaires and structured interview and underwent cold pressor testing. Results: Of 61 total participants, those in the PTSD (n =16) and other anxiety groups (n =12) endorsed significantly higher levels of psychological symptoms and poorer health functioning than control participants (n =33). The linear trend across baseline, threshold, and tolerance pain ratings from the cold pressor task significantly differed between participants with PTSD and the other anxiety and control groups suggesting lower pain sensitivity to a standardized stimulus of pain in individuals with PTSD. Conclusions: These findings are similar to some of the prior research and suggest that individuals with PTSD may exhibit lower cold pain sensitivity compared to those with other anxiety disorders. There is a need for future research to determine explanatory mechanisms. Keywords: PTSD, Anxiety, Pain sensitivity, Chronic pain, Comorbidity
Background A substantial body of literature has documented that anxiety disorders such as posttraumatic stress disorder (PTSD) and chronic pain often occur concurrently [1-5]. An estimated 11–60% of patients with chronic pain report the co-occurrence of various anxiety disorders [6]. Individuals with PTSD and chronic pain report higher ratings of psychiatric distress, greater disability, and more intense pain compared to those with PTSD or chronic pain only [7-9]. Despite substantial research on this comorbidity, little is * Correspondence: [email protected] 2 VA Center of Excellence for Stress and Mental Health (CESAMH) and the VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA 4 Department of Psychiatry, University of California, 9500 Gilman Drive, 0737, La Jolla, San Diego, CA 92093, USA Full list of author information is available at the end of the article
known about the mechanisms underlying these conditions that might be potentially similar across anxiety disorders including PTSD and chronic pain. Evoked pain sensitivity is one factor that has been associated with several pain conditions and extensively examined in the pain lit
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