Significant others' responses to pain in veterans with chronic pain and clinical levels of post-traumatic stress disorder symptomatology

Background Pain and post-traumatic stress disorder (PTSD) are two of the most common health complaints among US veterans. Studies suggest that the co-morbidity of these disorders exacerbates veterans experiences of chronic pain. Although a limited number of papers have reviewed reasons for this exacerbation, no studies have explored the potential contribution of significant others responses to veterans experience of pain in the context of PTSD symptomatology. The purpose of this study was to explore whether significant others responses to chronic pain differed for veterans with and without clinical levels of PTSD symptoms. It was hypothesized that veterans who presented with higher levels of PTSD symptomatology would report higher levels of punishing responses to their pain from significant others. Methods Participants were 184 veterans who completed self-report questionnaires as part of their participation in a Psychology Pain Management program at a Department of Veterans Affairs healthcare facility. Results Supporting our hypothesis, PTSD symptoms in veterans were associated with higher levels of punishing responses to pain from their significant others. Further, veterans who reported clinically significant levels of PTSD symptoms garnered more punishing responses to pain when compared with veterans with subclinical levels of PTSD symptomatology. Punishing responses to pain were associated with greater pain-related disability among veterans. Conclusions The presence of more punishing responses may impact the cognitive-behavioural components of the chronic pain experience. For example, it may worsen negative affect, which can thus impact the fear-avoidance model. Further discussion focuses on the implications of these results, including guidelines for clinical applications.