A Preliminary Examination of Treatment for Posttraumatic Stress Disorder in Chronic Pain Patients: A Case Study

Manualized treatments have become popular, despite concern about their use when comorbid diagnoses are present. In this report, the efficacy of manualized posttraumatic stress disorder (PTSD) treatment was examined in the presence of chronic pain. Additionally, the effect of PTSD treatment on chronic pain and additional psychiatric diagnoses was explored. Six female patients with both PTSD and chronic pain following motor vehicle accidents were treated for PTSD using a multiple baseline design. The results indicate that manualized treatment for PTSD was effective in reducing PTSD symptoms in these patients. Although there were no changes in subjective pain, there were pain-related functional improvements and reductions in other psychiatric diagnoses for the majority of patients.

[1]  R. Dworkin,et al.  A high-risk method for studying psychosocial antecedents of chronic pain: the prospective investigation of herpes zoster. , 1992, Journal of abnormal psychology.

[2]  W. Grove The Scientist Practitioner: Research and Accountability in Clinical and Educational Settings , 1986 .

[3]  D H Barlow,et al.  Reliability of DSM-III-R anxiety disorder categories. Using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). , 1993, Archives of general psychiatry.

[4]  J. Davidson,et al.  Clinician‐administered PTSD scale: A review of the first ten years of research , 2001, Depression and anxiety.

[5]  A. Harvey,et al.  Chronic pain and posttraumatic stress disorder: mutual maintenance? , 2001, Clinical psychology review.

[6]  Dennis S. Charney,et al.  A CLINICIAN RATING SCALE FOR ASSESSING CURRENT AND LIFETIME PTSD: THE CAPS-1 , 1990 .

[7]  M J Horowitz,et al.  Impact of Event Scale: a cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes. , 1982, Journal of consulting and clinical psychology.

[8]  M. A. Wehmer,et al.  The West Haven‐Yale Multidimensional Pain Inventory(WHYMPI) , 1990 .

[9]  David H. Barlow,et al.  The Scientist Practitioner: Research and Accountability in Clinical and Educational Settings , 1983 .

[10]  D. Antonacci,et al.  Clozapine treatment in a population of adults with mental retardation. , 2000, The Journal of clinical psychiatry.

[11]  Jacques Donders,et al.  After the Crash: Assessment and Treatment of Motor Vehicle Accident Survivors , 1998 .

[12]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[13]  D. Fishbain Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: a randomized, double-blind, placebo-controlled trial. , 2000, Pain.

[14]  N. Bogduk,et al.  Reply to Kendall et al., Pain, 73 (1997) 15-22. Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: a randomized, double-blind, placebo-controlled trial. , 1999, Pain.

[15]  E. Blanchard,et al.  Motor Vehicle Accidents, Headaches and Post‐Traumatic Stress Disorder: Assessment Findings in a Consecutive Series , 1992, Headache.

[16]  B. Cox,et al.  Posttraumatic Stress Disorder and Motor Vehicle Accidents: A Multidisciplinary Overview , 1996, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[17]  Ulf Lindblom,et al.  CLASSIFICATION OF CHRONIC PAIN , 2004 .

[18]  I. Baguley,et al.  Interaction of posttraumatic stress disorder and chronic pain following traumatic brain injury. , 1999, The Journal of head trauma rehabilitation.

[19]  L. Vandecreek,et al.  Innovations in Clinical Practice: A Source Book , 1992 .

[20]  K. Brady,et al.  Comorbidity of psychiatric disorders and posttraumatic stress disorder. , 2000, The Journal of clinical psychiatry.

[21]  D. Turk,et al.  The West Haven-Yale Multidimensional Pain Inventory (WHYMPI) , 1985, Pain.

[22]  J C Fairbank,et al.  The Oswestry low back pain disability questionnaire. , 1980, Physiotherapy.

[23]  Harald Breivik,et al.  International Association for the Study of Pain: update on WHO-IASP activities. , 2002, Journal of pain and symptom management.

[24]  R. Linn,et al.  Family burden following traumatic brain injury. , 1994 .

[25]  N. Bogduk,et al.  Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: a randomised, double-blind, placebo-controlled trial , 1997, Pain.

[26]  Loretta S. Malta,et al.  A controlled evaluation of cognitive behavioural therapy for posttraumatic stress in motor vehicle accident survivors. , 2003, Behaviour research and therapy.

[27]  P. Yarnold,et al.  Statistical Analysis for Single-Case Designs , 1991, Behavior modification.

[28]  M. Geisser,et al.  The relationship between symptoms of post-traumatic stress disorder and pain, affective disturbance and disability among patients with accident and non-accident related pain , 1996, PAIN®.