Stress-related psychological symptoms contribute to axial pain persistence after motor vehicle collision: Path analysis results from a prospective longitudinal study

Rose K. Feinberg, Junmei Hu, Mark A. Weaver, Roger B. Fillingim, Robert A. Swor, David A. Peak, Jeffrey S. Jones, Niels K. Rathlev, David C. Lee, Robert M. Domeier, Phyllis L. Hendry, Israel Liberzon, Samuel A. McLean

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Posttraumatic stress disorder (PTSD) symptoms and pain after traumatic events such as motor vehicle collision (MVC) have been proposed to be mutually promoting. We performed a prospective multicenter study that enrolled 948 individuals who presented to the emergency department within 24 hours of MVC and were discharged home after evaluation. Follow-up evaluations were completed 6 weeks, 6 months, and 1 year after MVC. Path analysis results supported the hypothesis that axial pain after MVC consistently promotes the maintenance of hyperarousal and intrusive symptoms, from the early weeks after injury through 1 year. In addition, path analysis results supported the hypothesis that one or more PTSD symptom clusters had an influence on axial pain outcomes throughout the year after MVC, with hyperarousal symptoms most influencing axial pain persistence in the initial months after MVC. The influence of hyperarousal symptoms on pain persistence was only present among individuals with genetic vulnerability to stress-induced pain, suggesting specific mechanisms by which hyperarousal symptoms may lead to hyperalgesia and allodynia. Further studies are needed to better understand the specific mechanisms by which pain and PTSD symptoms enhance one another after trauma, and how such mechanisms vary among specific patient subgroups, to better inform the development of secondary preventive interventions.

Original languageEnglish (US)
Pages (from-to)682-690
Number of pages9
JournalPain
Volume158
Issue number4
DOIs
StatePublished - Apr 1 2017

Keywords

  • Axial pain
  • Motor vehicle collision
  • Posttraumatic stress

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Stress-related psychological symptoms contribute to axial pain persistence after motor vehicle collision: Path analysis results from a prospective longitudinal study'. Together they form a unique fingerprint.

Cite this