Chronic Pain in Posttraumatic Stress Disorder: Re-experiencing of Peritraumatic Pain?

Background: Neuroscientific and survey studies have pointed to the existence of ´pain-intrusions´ in posttraumatic stress disorder (PTSD), i.e., medically unexplained re-experiencing of peritraumatic pain in the same body regions as during the traumatic event, possibly explaining the high comorbidity between PTSD and chronic pain. Previous survey studies in trauma-survivors have assessed pain-intrusions by directly asking about pain as a re-experience of the traumatic event—an approach susceptible to expectancy effects. Objective: Here, we systematically assessed chronic and peritraumatic pain to investigate to what degree chronic pain occurs in the same body regions as during the traumatic event. To shed further light on chronic pain as a re-experiencing symptom, we analyzed the role of PTSD symptoms and established predictors of intrusive re-experiencing (e.g., cumulative traumatic experiences, younger age at the earliest traumatic event, peritraumatic distress and dissociation, and trait rumination and anxiety sensitivity). Method: In a pre-registered online study, survivors of psychologically traumatizing events (N=330) reported chronic and peritraumatic pain in 108 predefined body regions, PTSD symptoms, and re-experiencing predictors. Results: Eleven percent of participants experienced pain-intrusions (i.e., chronic pain in the same body region as during the traumatic event). Experienced (vs. non-experienced) peritraumatic pain increased the likelihood of chronic pain in the same (odds-ratio=2.94), but not across all (odds-ratio=1.36) body regions. PTSD symptom severity and all assessed re-experiencing risk factors predicted pain-intrusion occurrence. Most participants with pain-intrusions were convinced of a trauma-related origin. Conclusion: Results support the notion that posttraumatic chronic pain may in part constitute pain re-experiencing associated with PTSD symptomatology, and that these pain-intrusions share risk factors with other re-experiencing symptoms.